Daniella Rosen, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9150 Issued in AZ

Practice address

6678 W Thunderbird Rd
Glendale, AZ 85306-3721

Phone

(602) 978-1500

Fax

(602) 978-0409

NPI assigned

Jan 23, 2020

Last updated

Apr 24, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Daniella Pourmoradi Former name

Medicare fee-for-service enrollment

Enrolled in CA, AZ2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Genesis OB GYN PLLCGroup PAC ID 4284724279, 109 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: daniella.rosen.1@19050.direct.athenahealth.com
• Direct secure messaging: daniella.rosen.p1@direct.dwobgyn.nextgenshare.com

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.

• Genesis OB GYN PLLC

  • Obstetrics & Gynecology Physician
  • Tucson, AZ
  • NPI 1992994214
  Medicare reassignment Care Compare group
• Desert West Obstetrics & Gynecology LTD

  • Obstetrics & Gynecology Physician
  • Glendale, AZ
  • NPI 1588654560
  Medicare reassignment
• Mint Health Solutions, Inc

  • Internal Medicine Physician
  • Pasadena, CA
  • NPI 1316543119
  Medicare reassignment

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

{
    "created_epoch": "1579737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1619507233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6678 W THUNDERBIRD RD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853063721",
            "telephone_number": "602-978-1500",
            "fax_number": "602-978-0409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6678 W THUNDERBIRD RD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853063721",
            "telephone_number": "602-978-1500",
            "fax_number": "602-978-0409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEN",
        "first_name": "DANIELLA",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-23",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "9150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIELLA",
            "last_name": "POURMORADI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rosarian Assisted Living
• Rose Pedal LLC
• Michael Richard Rose, LCSW, PH.D.
• Cindy K Rosek, NP-C
• Jodi Roselius-Bagley, LMT
• Lara E. Rosenbaum, M.D.
• Brandon Rosenberg
• Ron Rosenwald, MD
• Jamie Ross
• Jenna Lynn Ross, LPC

• Physician Assistant in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.