Active NPI
Jake Rosenberg
- Psychiatry Physician
- Marlton, NJ
National Provider Identifier
1619234556
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 25MA09986300
- Practice address
- 3000 Lincoln Dr E
Marlton, NJ 08053-1500 - Phone
- (267) 292-9400
- NPI assigned
- Apr 17, 2012
- Last updated
- Jul 31, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 25MA09986300 | NJ | Primary |
Addresses
Primary practice location
3000 Lincoln Dr E
Marlton, NJ 08053-1500
Mailing address
39 Treaty Elm LN
Haddonfield, NJ 08033-3413
Phone (267) 980-8177
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 23, 2023 through Jan 23, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- jake.roseberg@centerforemotionalfitness.chartmakerdirect.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1334620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690761600000",
"number": "1619234556",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "39 TREATY ELM LN",
"city": "HADDONFIELD",
"state": "NJ",
"postal_code": "080333413",
"telephone_number": "267-980-8177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 LINCOLN DR E",
"city": "MARLTON",
"state": "NJ",
"postal_code": "080531500",
"telephone_number": "267-292-9400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSENBERG",
"first_name": "JAKE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-04-17",
"last_updated": "2023-07-31",
"certification_date": "2023-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NJ",
"license": "25MA09986300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marlton, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.