Individual provider Active NPI

Peter Leonard Rose Jr., MD

  • Anesthesiology Physician
  • Ocoee, FL
National Provider Identifier
1609803311
Registry record updated May 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
ME47393 Issued in FL
Practice address
10000 W Colonial Dr
Ocoee, FL 34761-3498
Phone
(407) 667-0444
Fax
(407) 667-4338
NPI assigned
Jun 27, 2006
Last updated
May 8, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X ME47393 FL Primary

Addresses

Primary practice location

10000 W Colonial Dr
Ocoee, FL 34761-3498

Mailing address

1901 Ulmerton Rd Ste 485
Clearwater, FL 33762-2312
Phone (503) 309-8968

Other identifiers 2

IdentifierTypeStateIssuer
376930500MedicaidFL
26454OtherFLBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20100708000865 FL Practitioner - Anesthesiology 6002947082 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME47393FLMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Anesthesia Consultants PA Anesthesiology CurrentSince Dec 28, 2001 Accepting new patients
US Anesthesia Partners of Florida Inc. Anesthesiology CurrentSince Oct 13, 2015 Accepting new patients

Locations

1901 Ulmerton Rd
Ste 485
Clearwater, FL 33762

201 Mohawk Rd
Minneola, FL 34715
Phone (973) 979-9079

10000 W Colonial Dr
Ocoee, FL 34761
Phone (321) 843-1378

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

88 W Kaley St
Orlando, FL 32806
Phone (407) 423-0573

Organizations & group practices 2

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": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557273600000",
    "number": "1609803311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 ULMERTON RD STE 485",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337622312",
            "telephone_number": "503-309-8968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 W COLONIAL DR",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347613498",
            "telephone_number": "407-667-0444",
            "fax_number": "407-667-4338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "PETER",
        "middle_name": "LEONARD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2019-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME47393",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "376930500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "26454",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocoee, FL

Sources for this page

Verify at the official NPI Registry.