Individual provider Active NPI

Justin Michael Roseman, MS, PA-C

  • Cardiovascular Disease Physician
  • East Setauket, NY
National Provider Identifier
1619647591
Registry record updated Sep 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
027225 Issued in NY
Practice address
45 Research Way Ste 108
East Setauket, NY 11733-6401
Phone
(631) 941-2000
NPI assigned
Sep 14, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 027225 NY Primary

Addresses

Primary practice location

45 Research Way Ste 108
East Setauket, NY 11733-6401

Mailing address

45 Research Way Ste 108
East Setauket, NY 11733-6401
Phone (631) 941-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20220127000278 NY Practitioner - Physician Assistant 5799177689 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
027225NYMDPsychologist

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

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": "1631577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1619647591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 RESEARCH WAY STE 108",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117336401",
            "telephone_number": "631-941-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 RESEARCH WAY STE 108",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117336401",
            "telephone_number": "631-941-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEMAN",
        "first_name": "JUSTIN",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "MS, PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-14",
        "last_updated": "2021-09-14",
        "certification_date": "2021-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "027225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Setauket, NY

Sources for this page

Verify at the official NPI Registry.