Individual provider Active NPI

Alice Lucille Rose, N.P.

  • Adult Health Nurse Practitioner
  • Norwood, MA
National Provider Identifier
1558623504
Registry record updated Jun 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
121890 Issued in MA
Practice address
99 Access Road
Norwood, MA 02062
Phone
(781) 551-8006
Fax
(781) 551-8004
NPI assigned
Jun 14, 2012
Last updated
Jun 14, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 121890 MA Primary

Addresses

Primary practice location

99 Access Road
Norwood, MA 02062

Mailing address

51 Pettee St #34
Newton, MA 02464
Phone (617) 969-7719

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20250227003663 MA Order and Referring Only - Nurse Practitioner 2365477304

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
121890MAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Schwartz Medical Group PastSince Jan 15, 2017 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9395/brand/1/csg/1/fhir/r4

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
South Cove Manor at Quincy Point Rehabilitation CenterQuincy, MA, CCN 225514 Skilled nursing facility Corporate Director Feb 16, 2011

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1339632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339632000000",
    "number": "1558623504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 PETTEE ST #34",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "02464",
            "telephone_number": "617-969-7719",
            "fax_number": "781-453-7347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 ACCESS ROAD",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "02062",
            "telephone_number": "781-551-8006",
            "fax_number": "781-551-8004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "ALICE",
        "middle_name": "LUCILLE",
        "name_prefix": "Ms.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-14",
        "last_updated": "2012-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "121890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwood, MA

Sources for this page

Verify at the official NPI Registry.