Individual provider Active NPI

Gary Howard Rosen, M.D.

  • Family Medicine Physician
  • Pasadena, TX
National Provider Identifier
1609984772
Registry record updated Jul 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E7726 Issued in TX
Practice address
4117 Pasadena Blvd
Pasadena, TX 77503-3534
Phone
(281) 476-9229
Fax
(281) 476-1913
NPI assigned
Aug 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E7726 TX Primary

Addresses

Primary practice location

4117 Pasadena Blvd
Pasadena, TX 77503-3534

Mailing address

4117 Pasadena Blvd
Pasadena, TX 77503-3534
Phone (281) 476-9229

Other identifiers 1

IdentifierTypeStateIssuer
P000CE579MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20111020000299 TX Practitioner - General PracticePractitioner - Family Practice 1759553589 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General PracticeAlso: Family Practice
Education
Other, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4117 Pasadena Blvd
Pasadena, TX 77503-3534
Phone (281) 476-9229

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E7726TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gary H Rosen MD PA Family Medicine CurrentSince Nov 18, 2010 Accepting new patients

Locations

4117 Pasadena Blvd
Pasadena, TX 77503
Phone (281) 476-9229

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278892800000",
    "number": "1609984772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4117 PASADENA BLVD",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775033534",
            "telephone_number": "281-476-9229",
            "fax_number": "281-476-1913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4117 PASADENA BLVD",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775033534",
            "telephone_number": "281-476-9229",
            "fax_number": "281-476-1913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEN",
        "first_name": "GARY",
        "middle_name": "HOWARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-28",
        "last_updated": "2010-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "E7726",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "P000CE579",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, TX

Sources for this page

Verify at the official NPI Registry.