Individual provider Active NPI

Jay S Rosen, MD

  • Urology Physician
  • Oradell, NJ
National Provider Identifier
1477521706
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
25MA03775800 Issued in NJ
Practice address
555 Kinderkamack Rd
Oradell, NJ 07649-1517
Phone
(201) 791-4544
Fax
(201) 791-6585
NPI assigned
Mar 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 25MA03775800 NJ Primary

Addresses

Primary practice location

555 Kinderkamack Rd
Oradell, NJ 07649-1517

Mailing address

15-01 Broadway, RT 4 West
Suites 1 & 3
Fair Lawn, NJ 07410
Phone (201) 791-4544

Other identifiers 1

IdentifierTypeStateIssuer
2087308MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060117000732 NJ Practitioner - Urology 8527082684 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sovereign Medical Group LLCGroup PAC ID 1456535392, 20 clinicians

Practice addresses (Care Compare)

680 Kinderkamack Rd
Suite 300
Oradell, NJ 07649-1600
Phone (201) 834-1890

Hospital & facility affiliations

  • Hackensack University Medical Center Hospital, Hackensack, NJ, CCN 310001
  • Valley Hospital Hospital, Paramus, NJ, CCN 310012
  • The University Hospital Hospital, Newark, NJ, CCN 310119

Merit-based Incentive Payment System (MIPS)

Final score
95.05 of 100Reported as apm
Quality
85.71
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection19

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA03775800NJMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sovereign Medical Group LLC Urology CurrentSince Mar 1, 2011 Accepting new patients
Sovereign Medical Group, LLC CurrentSince Mar 1, 2011 Accepting new patients
Urology Specialty Care PA Past Accepting new patients

Locations

630 Broad St
Fl 2
Carlstadt, NJ 07072

15-01 Broadway
Ste 1
Fair Lawn, NJ 07410
Phone (201) 703-8487

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

555 Kinderkamack Rd
Ste D
Oradell, NJ 07649
Phone (201) 265-1133

680 Kinderkamack Rd
Ste 300
Oradell, NJ 07649
Phone (201) 881-7869

Interoperability endpoints

  • Direct secure messaging: jay.rosen.2@5622.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1142035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1477521706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15-01 BROADWAY, RT 4 WEST",
            "address_2": "SUITES 1 & 3",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "07410",
            "telephone_number": "201-791-4544",
            "fax_number": "201-791-6585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 KINDERKAMACK RD",
            "city": "ORADELL",
            "state": "NJ",
            "postal_code": "076491517",
            "telephone_number": "201-791-4544",
            "fax_number": "201-791-6585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEN",
        "first_name": "JAY",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-11",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NJ",
            "license": "25MA03775800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2087308",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oradell, NJ

Sources for this page

Verify at the official NPI Registry.