NPIMap

Individual provider Active NPI

David Ian Rose, M.D.

  • Diagnostic Radiology Physician
  • Boston, MA
National Provider Identifier
1477528677
Registry record updated Oct 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
154584 Issued in MA
Practice address
75 Francis St
Boston, MA 02115-6110
Phone
(617) 732-6269
NPI assigned
Feb 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 154584 MA Primary

Addresses

Primary practice location

75 Francis St
Boston, MA 02115-6110

Mailing address

35 Stone Root LN
Sudbury, MA 01776-1321
Phone (978) 440-8258

Other identifiers 1

IdentifierTypeStateIssuer
3182002MedicaidMA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101118000381 MA Practitioner - Diagnostic Radiology 3678461290 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Perelman School of Med at the University of Pennsylvania, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emerson Practice Associates, IncGroup PAC ID 8123188117, 247 clinicians
North Bridge Imaging Group, LLCGroup PAC ID 3577451178, 16 clinicians

Practice addresses (Care Compare)

133 Old Rd to 9 Acre Cor
Concord, MA 01742-4159
Phone (978) 287-3020

133 Old Rd to Nine Acre Corner
Radiology Department
Concord, MA 01742-4159
Phone (978) 287-3794

Hospital & facility affiliations

  • Emerson Hospital - Hospital, W Concord, MA, CCN 220084
  • Massachusetts General Hospital Hospital, Boston, MA, CCN 220071
  • Lowell General Hospital Hospital, Lowell, MA, CCN 220063
  • Beth Israel Deaconess Medical Center Hospital, Boston, MA, CCN 220086
  • Lahey Hospital & Medical Center, Burlington Hospital, Burlington, MA, CCN 220171

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
154584MAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Bridge Imaging Group, LLC CurrentSince Aug 5, 1998 Accepting new patients
Emerson Practice Associates, Inc. CurrentSince Mar 1, 2018 Accepting new patients
North Bridge Imaging Group, LLC CurrentSince Aug 5, 1998 Accepting new patients
Emerson Hospital PastSince Apr 1, 2013 Accepting new patients

Locations

75 Francis St
Boston, MA 02115

133 Ornac
Concord, MA 01742
Phone (978) 287-3000

2527 Cranberry Hwy
Wareham, MA 02571
Phone (508) 295-5556

10 Little Brook Rd
West Wareham, MA 02576

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Emerson HospitalConcord, MA, CCN 220084 Hospital Corporate Director Oct 6, 2010
Emerson HospitalConcord, MA, CCN 22S084 Hospital Corporate Director Apr 1, 2013
Emerson Hospital Home Care/HospiceConcord, MA, CCN 227072 Home health agency Corporate Director Apr 1, 2013

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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 5

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": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350864000000",
    "number": "1477528677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 STONE ROOT LN",
            "city": "SUDBURY",
            "state": "MA",
            "postal_code": "017761321",
            "telephone_number": "978-440-8258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 FRANCIS ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156110",
            "telephone_number": "617-732-6269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "DAVID",
        "middle_name": "IAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2012-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "154584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3182002",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.