Individual provider Active NPI

Ronald William Rosenberg, MD

  • Psychosomatic Medicine Physician
  • Bloomfield Hills, MI
National Provider Identifier
1568680866
Registry record updated Mar 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychosomatic Medicine PhysicianTaxonomy code 2084P0015X
License
46516 Issued in MI
Practice address
6431 Inkster Rd
Suite 226
Bloomfield Hills, MI 48301-1310
Phone
(248) 602-0011
Fax
(888) 391-5251
NPI assigned
Apr 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychosomatic Medicine Physician 2084P0015X 46516 MI Primary

Addresses

Primary practice location

6431 Inkster Rd
Suite 226
Bloomfield Hills, MI 48301-1310

Mailing address

6431 Inkster Rd
Suite 226
Bloomfield Hills, MI 48301-1310
Phone (248) 602-0011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20190627000757 AZ Practitioner - Psychiatry 7214910009 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
46516MIMDPsychosomatic Medicine Physician
31482SCMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sierra Vista Regional Health Center Medical Group LLC Psychiatry CurrentSince May 12, 2019 Accepting new patients

Locations

5700 E Highway 90
Sierra Vista, AZ 85635
Phone (520) 263-2000

5750 E Highway 90
Ste 200
Sierra Vista, AZ 85635
Phone (520) 263-3500

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": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489536000000",
    "number": "1568680866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6431 INKSTER RD",
            "address_2": "SUITE 226",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483011310",
            "telephone_number": "248-602-0011",
            "fax_number": "888-391-5251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6431 INKSTER RD",
            "address_2": "SUITE 226",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483011310",
            "telephone_number": "248-602-0011",
            "fax_number": "888-391-5251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBERG",
        "first_name": "RONALD",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-23",
        "last_updated": "2017-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0015X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychosomatic Medicine",
            "state": "MI",
            "license": "46516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield Hills, MI

Sources for this page

Verify at the official NPI Registry.