Active NPI
Charles J Rosser, MD
- Urology Physician
- West Hollywood, CA
National Provider Identifier
1508831017
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- C158684
- Practice address
- 8700 Beverly Blvd
West Hollywood, CA 90048-1804 - Phone
- (310) 423-5000
- NPI assigned
- Feb 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 9600268 | NC | |
| Urology Physician | 208800000X | L1189 | TX | |
| Urology Physician | 208800000X | ME88129 | FL | |
| Urology Physician | 208800000X | C158684 | CA | Primary |
Addresses
Primary practice location
8700 Beverly Blvd
West Hollywood, CA 90048-1804
Mailing address
4140 W 190TH St
Torrance, CA 90504-5513
Other practice location 1
888 South King Street
Honolulu, HI 96813
Phone (808) 522-4000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 267305300 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C158684 | CA | MD | Urology Physician |
| 9600268 | NC | MD | Urology Physician |
| L1189 | TX | MD | Urology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nonagen Bioscience Corporation | Current | Accepting new patients |
Interoperability endpoints
- crosser221487@direct.cshs.org
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.
-
- Clinical Medical Laboratory
- Irvine, CA
- NPI 1124970058
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140307200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1570147200000",
"number": "1508831017",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4140 W 190TH ST",
"city": "TORRANCE",
"state": "CA",
"postal_code": "905045513"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8700 BEVERLY BLVD",
"city": "WEST HOLLYWOOD",
"state": "CA",
"postal_code": "900481804",
"telephone_number": "310-423-5000"
}
],
"practiceLocations": [
{
"address_1": "888 South King Street",
"address_purpose": "LOCATION",
"city": "Honolulu",
"state": "HI",
"postal_code": "96813",
"country_code": "US",
"telephone_number": "808-522-4000",
"fax_number": "407-425-5203",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROSSER",
"first_name": "CHARLES",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-19",
"last_updated": "2019-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "NC",
"license": "9600268",
"primary": false
},
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "TX",
"license": "L1189",
"primary": false
},
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "FL",
"license": "ME88129",
"primary": false
},
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "CA",
"license": "C158684",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "267305300",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in West Hollywood, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.