Individual provider Active NPI

Debra Rosett, ANP, PT, CHT

  • Adult Health Nurse Practitioner
  • Berkeley, CA
National Provider Identifier
1467720862
Registry record updated Nov 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
18532 Issued in CA
Practice address
2222 Bancroft Way
Berkeley, CA 94720-4300
Phone
(510) 642-6891
NPI assigned
Dec 13, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT 14582 CA
Adult Health Nurse Practitioner 363LA2200X 18532 CA Primary

Addresses

Primary practice location

2222 Bancroft Way
Berkeley, CA 94720-4300

Mailing address

2222 Bancroft Way
Berkeley, CA 94720-4300
Phone (510) 642-6891

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130809000567 CA Order and Referring Only - Nurse Practitioner 8123260783

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 14582CAMDPhysical Therapist
18532CAMDAdult Health Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1323734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352419200000",
    "number": "1467720862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 BANCROFT WAY",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947204300",
            "telephone_number": "510-642-6891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 BANCROFT WAY",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947204300",
            "telephone_number": "510-642-6891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSETT",
        "first_name": "DEBRA",
        "name_prefix": "Ms.",
        "credential": "ANP, PT, CHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-13",
        "last_updated": "2012-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 14582",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "18532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.