Individual provider Active NPI

Elana Michelle Pine Rosenberg, WHNP-BC

  • Women's Health Nurse Practitioner
  • Barre, VT
National Provider Identifier
1497421580
Registry record updated Oct 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
101.0136284 Issued in VT
Practice address
90 Washington St
Barre, VT 05641-4253
Phone
(802) 476-6696
NPI assigned
Aug 18, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 101.0136284 VT Primary

Addresses

Primary practice location

90 Washington St
Barre, VT 05641-4253

Mailing address

784 Hercules Dr Ste 110
Colchester, VT 05446-8049
Phone (802) 448-9787

Other identifiers 1

IdentifierTypeStateIssuer
6714046MedicaidVT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230807001847 VT Practitioner - Nurse Practitioner 6406217421 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Yale University School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Planned Parenthood of Northern New England, IncGroup PAC ID 8729069505, 41 clinicians

Practice addresses (Care Compare)

173 Saint Paul St
Burlington, VT 05401-4636
Phone (802) 863-6326

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
101.0136284VTMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Planned Parenthood of Northern New England, Inc CurrentSince Jul 24, 2023 Accepting new patients
Planned Parenthood of Northern New England PastSince May 7, 2023 Accepting new patients

Locations

90 Washington St
Barre, VT 05641
Phone (802) 475-6696

173 Saint Paul St
Burlington, VT 05401
Phone (802) 863-6326

784 Hercules Dr
Ste 110
Colchester, VT 05446
Phone (802) 448-9784

501 Portland St
St Johnsbury, VT 05819
Phone (802) 363-3209

79 S Main St
White River Junction, VT 05001
Phone (802) 281-6056

75 Talcott Rd
Ste 10
Williston, VT 05495
Phone (802) 879-4800

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1629244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696809600000",
    "number": "1497421580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "784 HERCULES DR STE 110",
            "city": "COLCHESTER",
            "state": "VT",
            "postal_code": "054468049",
            "telephone_number": "802-448-9787",
            "fax_number": "802-448-9787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 WASHINGTON ST",
            "city": "BARRE",
            "state": "VT",
            "postal_code": "056414253",
            "telephone_number": "802-476-6696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBERG",
        "first_name": "ELANA",
        "middle_name": "MICHELLE PINE",
        "credential": "WHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-18",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "VT",
            "license": "101.0136284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6714046",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Barre, VT

Sources for this page

Verify at the official NPI Registry.