Individual provider Active NPI

Deanna Rosenberg

  • Physician Assistant
  • Katonah, NY
National Provider Identifier
1568023646
Registry record updated Jun 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
10 Sawgrass Dr
Katonah, NY 10536-2703
Phone
(914) 400-5667
NPI assigned
Jun 27, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA Primary

Addresses

Primary practice location

10 Sawgrass Dr
Katonah, NY 10536-2703

Mailing address

10 Sawgrass Dr
Katonah, NY 10536-2703
Phone (914) 400-5667

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20210728002705 NY Practitioner - Physician Assistant 1759710544 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Southern California Keck School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bobby Buka, M.D., P.C.Group PAC ID 0547351140, 140 clinicians

Practice addresses (Care Compare)

114 Greenpoint Ave
Brooklyn, NY 11222-5768
Phone (212) 385-3700

220 Front St
New York, NY 10038-2033
Phone (212) 385-3700

3179 Steinway St
Astoria, NY 11103-3908
Phone (212) 385-3700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
024961NYMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bobby Buka, M.D., P.C. CurrentSince Aug 1, 2021 Accepting new patients
Derm Specs of PA PLLC PastSince Feb 25, 2024 Accepting new patients
Out East Medical PastSince Jun 15, 2021 Accepting new patients
Atlas Infectious Disease Practice PLLC Past Accepting new patients
Mount Sinai Hospital Past Accepting new patients

Locations

3179 Steinway St
Astoria, NY 11103

1163 Myrtle Ave
Brooklyn, NY 11206

1027 46th Ave
Fl 1
Long Island City, NY 11101

625 10th Ave
New York, NY 10036

1425 2nd Ave
New York, NY 10021

2121 Adam Clayton Powell Jr Blvd
New York, NY 10027
Phone (718) 534-8190

214 Sullivan St
New York, NY 10012

3531 Long Beach Rd
Oceanside, NY 11572

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22363/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/BFCDAA

Organizations & group practices 5

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": "1561593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561593600000",
    "number": "1568023646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 SAWGRASS DR",
            "city": "KATONAH",
            "state": "NY",
            "postal_code": "105362703",
            "telephone_number": "914-400-5667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 SAWGRASS DR",
            "city": "KATONAH",
            "state": "NY",
            "postal_code": "105362703",
            "telephone_number": "914-400-5667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBERG",
        "first_name": "DEANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-27",
        "last_updated": "2019-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Katonah, NY

Sources for this page

Verify at the official NPI Registry.