Active NPI
Harris Samuel Rose, M.D.
- Orthopaedic Hand Surgery Physician
- Austin, TX
National Provider Identifier
1558304196
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Hand Surgery Physician
- License
- M4488
- Practice address
- 11652 Jollyville Rd
Austin, TX 78759-3935 - Phone
- (512) 551-0375
- Fax
- (512) 551-0634
- NPI assigned
- Jun 13, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | M4488 | TX | |
| Orthopaedic Hand Surgery Physician | 207XS0106X | M4488 | TX | Primary |
Addresses
Primary practice location
11652 Jollyville Rd
Austin, TX 78759-3935
Mailing address
11652 Jollyville Rd
Austin, TX 78759-3935
Phone (512) 551-0375
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 |
|---|---|---|---|
| M4488 | TX | MD | Orthopaedic Hand Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572825600000",
"number": "1558304196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11652 JOLLYVILLE RD",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787593935",
"telephone_number": "512-551-0375",
"fax_number": "512-551-0634"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11652 JOLLYVILLE RD",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787593935",
"telephone_number": "512-551-0375",
"fax_number": "512-551-0634"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSE",
"first_name": "HARRIS",
"middle_name": "SAMUEL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-13",
"last_updated": "2019-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "TX",
"license": "M4488",
"primary": false
},
{
"code": "207XS0106X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Hand Surgery",
"state": "TX",
"license": "M4488",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 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.