Mark Richard Rosenberg, DO

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

2245 Issued in AZ

Practice address

20950N Tatum Blvd 350
Phoenix, AZ 85050-4256

Phone

(480) 502-6651

Fax

(480) 513-8253

NPI assigned

Sep 11, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

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.

• West Dermatology of Arizona, Inc

  • Dermatology Physician
  • Mesa, AZ
  • NPI 1902850597
  NPD (past)

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458086400000",
    "number": "1598869687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2285 CORPORATE CIR",
            "address_2": "STE 200",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890747759",
            "telephone_number": "702-360-2763",
            "fax_number": "949-783-2880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20950N TATUM BLVD 350",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850504256",
            "telephone_number": "480-502-6651",
            "fax_number": "480-513-8253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBERG",
        "first_name": "MARK",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-11",
        "last_updated": "2016-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AZ",
            "license": "2245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE WEST DERM OF AZ",
            "identifier": "P00633842",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE 4/2010 UNDER PTAN DP3049",
            "identifier": "P00809240",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Seymour L Rosen, DDS
• Daniel J Rosenbaum, PH.D.
• Louis J Rosenbaum, MD
• Tanika Rosenbaum
• Christine Feltman Rosenberg, OTR
• Robert Arlen Rosenberg, MD
• Robert B Rosenberg, M.D.
• Gerald Arthur Rosenblum, MD
• Holly Anne Rosenblum, ED.S.
• Gianna Rosenboom

• Dermatology Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Dermatology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.