Individual provider Active NPI

Michael S. Rosenbaum, PH.D.

  • Clinical Psychologist
  • Delray Beach, FL
National Provider Identifier
1508830910
Registry record updated Mar 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
330 Issued in AL
Practice address
13610 Cambria Bay LN
Delray Beach, FL 33446-5660
Phone
(251) 344-1482
Fax
(561) 359-2836
NPI assigned
Feb 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY10113 FL
Clinical Psychologist 103TC0700X 330 AL Primary

Addresses

Primary practice location

13610 Cambria Bay LN
Delray Beach, FL 33446-5660

Mailing address

13610 Cambria Bay LN
Delray Beach, FL 33446-5660
Phone (251) 554-4927

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230321001169 FL Practitioner - Clinical Psychologist 1759577901 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grow Healthcare Group PAGroup PAC ID 3476961368, 1,045 clinicians

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807
Phone (786) 244-7711

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PY10113FLMDClinical Psychologist
330ALMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA CurrentSince Feb 10, 2023 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 1

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": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678233600000",
    "number": "1508830910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13610 CAMBRIA BAY LN",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334465660",
            "telephone_number": "251-554-4927",
            "fax_number": "561-359-2836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13610 CAMBRIA BAY LN",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334465660",
            "telephone_number": "251-344-1482",
            "fax_number": "561-359-2836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBAUM",
        "first_name": "MICHAEL",
        "middle_name": "S.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY10113",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AL",
            "license": "330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delray Beach, FL

Sources for this page

Verify at the official NPI Registry.