Individual provider Active NPI

Charles David Rosen, M.D.

  • Orthopaedic Surgery of the Spine Physician
  • Orange, CA
National Provider Identifier
1548264013
Registry record updated Apr 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
G53395 Issued in CA
Practice address
101 The City Dr S
Orange, CA 92868-3201
Phone
(714) 534-0547
Fax
(714) 456-7547
NPI assigned
Jun 12, 2005
Reactivated
Mar 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine Physician 207XS0117X G53395 CA Primary

Addresses

Primary practice location

101 The City Dr S
Orange, CA 92868-3201

Mailing address

1601 N Sepulveda Blvd
# 747
Manhattan Beach, CA 90266-5111
Phone (714) 534-0547

Other identifiers 1

IdentifierTypeStateIssuer
00G533950MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041216000644 CA Practitioner - Orthopedic Surgery 6901863323 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of California, San Diego School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the University of CaliforniaGroup PAC ID 4486550183, 48 clinicians

Practice addresses (Care Compare)

101 The City Dr S
Orange, CA 92868-3201
Phone (714) 456-7004

Hospital & facility affiliations

  • Uci Health-Orange Hospital, Orange, CA, CCN 050348

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
83.7
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion12

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53395CAMDMarriage & Family Therapist
G53395CAMDOrthopaedic Surgery of the Spine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince Oct 1, 2002 Accepting new patients
University of California Irvine Past Accepting new patients

Locations

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

101 The City Dr S
Bldg 29
Orange, CA 92868
Phone (714) 456-7005

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.

Hospital & facility affiliations 2

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": "1118534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272585600000",
    "number": "1548264013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 N SEPULVEDA BLVD",
            "address_2": "# 747",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902665111",
            "telephone_number": "714-534-0547",
            "fax_number": "714-456-7547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 THE CITY DR S",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683201",
            "telephone_number": "714-534-0547",
            "fax_number": "714-456-7547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEN",
        "first_name": "CHARLES",
        "middle_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-12",
        "last_updated": "2010-04-30",
        "deactivation_date": "2006-03-16",
        "reactivation_date": "2006-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "CA",
            "license": "G53395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G533950",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.