Individual provider Active NPI

Rose Pitkin

  • Pediatrics Physician
  • Lowell, MA
National Provider Identifier
1619558434
Registry record updated Mar 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
1022852 Issued in MA
Practice address
295 Varnum Ave
Lowell, MA 01854-2193
Phone
(978) 937-6000
NPI assigned
Apr 15, 2021
Last updated
Mar 17, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 1022852 MA Primary

Addresses

Primary practice location

295 Varnum Ave
Lowell, MA 01854-2193

Mailing address

800 Washington St
Boston, MA 02111-1552

Other practice location 1

5841 S Maryland Ave # Mc8016
Chicago, IL 60637-1443
Phone (773) 702-6435

Other practice location 2

370 Bassett Rd
North Haven, CT 06473-4201
Phone (413) 563-4773

Other practice location 3

680 Centre St
Brockton, MA 02302-3308
Phone (508) 941-7150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20250610004165 MA Practitioner - Pediatric Medicine 5799214094 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1022852MAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pratt Pediatric Associates Inc Single Specialty CurrentSince Jul 1, 2025 Accepting new patients
Signature Healthcare Medical Group Inc Single Specialty CurrentSince Apr 1, 2026 Accepting new patients
The Lowell General Hospital Single Specialty Past Accepting new patients
Lawrence General Hospital Single Specialty Past Accepting new patients

Locations

800 Washington St
Boston, MA 02111
Phone (617) 636-4800

680 Centre St
Brockton, MA 02302
Phone (508) 941-7400

295 Varnum Ave
Lowell, MA 01854
Phone (978) 788-7344

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/d04f75c7-2a62-4686-b520-7bf0635f38f0/
  • Direct secure messaging: rose.pitkin.1@11074.direct.athenahealth.com

Organizations & group practices 4

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": "1618444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773705600000",
    "number": "1619558434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 WASHINGTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 VARNUM AVE",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018542193",
            "telephone_number": "978-937-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5841 S Maryland Ave # Mc8016",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606371443",
            "country_code": "US",
            "telephone_number": "773-702-6435",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "370 Bassett Rd",
            "address_purpose": "LOCATION",
            "city": "North Haven",
            "state": "CT",
            "postal_code": "064734201",
            "country_code": "US",
            "telephone_number": "413-563-4773",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "680 Centre St",
            "address_purpose": "LOCATION",
            "city": "Brockton",
            "state": "MA",
            "postal_code": "023023308",
            "country_code": "US",
            "telephone_number": "508-941-7150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PITKIN",
        "first_name": "ROSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-15",
        "last_updated": "2026-03-17",
        "certification_date": "2026-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "1022852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lowell, MA

Sources for this page

Verify at the official NPI Registry.