Individual provider Active NPI

Donald Edward Rose, D.O.

  • Family Medicine Physician
  • Colusa, CA
National Provider Identifier
1619992823
Registry record updated Feb 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A6476 Issued in CA
Practice address
199 E Webster St
Colusa, CA 95932-2954
Phone
(530) 458-3283
Fax
(530) 458-3215
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 2008

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 20A6476 CA Primary

Addresses

Primary practice location

199 E Webster St
Colusa, CA 95932-2954

Mailing address

4214 Meadow Wood CT
El Dorado Hills, CA 95762-7529
Phone (916) 933-8804

Other identifiers 1

IdentifierTypeStateIssuer
00AX64760MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20050202001098 CA Practitioner - Osteopathic Manipulative MedicinePractitioner - General PracticePractitioner - Emergency Medicine 3173574597 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Osteopathic Manipulative Medicine
Education
Oklahoma State University College of Osteopathic Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4062 Flying C Rd
Suite 41
Cameron Park, CA 95682-9664
Phone (530) 676-8234

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A6476CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vituity - Urgent Care Services PC Family Medicine Current Accepting new patients
Colusa Emergency Physicians Medical Group, Inc. Past Accepting new patients
Valley Emergency Physicians Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: donald.rose.1@20515.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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203379200000",
    "number": "1619992823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4214 MEADOW WOOD CT",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957627529",
            "telephone_number": "916-933-8804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 E WEBSTER ST",
            "city": "COLUSA",
            "state": "CA",
            "postal_code": "959322954",
            "telephone_number": "530-458-3283",
            "fax_number": "530-458-3215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "DONALD",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2008-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A6476",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX64760",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colusa, CA

Sources for this page

Verify at the official NPI Registry.