NPIMap

Individual provider Active NPI

Ryan Matthew Rosebrough, MPAS, PA-C

  • Physician Assistant
  • Indianapolis, IN
National Provider Identifier
1487027058
Registry record updated Nov 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2203 Allison Ave
Indianapolis, IN 46224-5024
Phone
(317) 292-2153
NPI assigned
Nov 4, 2015
Last updated
Nov 4, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

2203 Allison Ave
Indianapolis, IN 46224-5024

Mailing address

2203 Allison Ave
Indianapolis, IN 46224-5024

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20160126001311 IN Practitioner - Physician Assistant 8022311034 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northside Gastroenterology, Inc., PCGroup PAC ID 7618981523, 10 clinicians

Practice addresses (Care Compare)

8424 Naab Rd
Suite 3J
Indianapolis, IN 46260-1975
Phone (317) 872-7396

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
69.63 of 100Reported as group
Quality
44.1
Improvement activities
40
Cost
73.29

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Gastroenterology Endoscopy Center LLC Current Accepting new patients
Major Hospital Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ryanrosebrough@ng.allscriptsdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1446595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446595200000",
    "number": "1487027058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2203 ALLISON AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462245024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2203 ALLISON AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462245024",
            "telephone_number": "317-292-2153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEBROUGH",
        "first_name": "RYAN",
        "middle_name": "MATTHEW",
        "name_prefix": "Mr.",
        "credential": "MPAS, PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-11-04",
        "last_updated": "2015-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.