Individual provider Active NPI

Alan H. Rosenbaum, MD

  • Psychiatry Physician
  • Commerce TWP, MI
National Provider Identifier
1629042528
Registry record updated Nov 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
4301027031 Issued in MI
Practice address
2619 Kingstowne Dr
Commerce TWP, MI 48390-2712
Phone
(248) 539-0200
Fax
(248) 539-0987
NPI assigned
Feb 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 4301027031 MI Primary

Addresses

Primary practice location

2619 Kingstowne Dr
Commerce TWP, MI 48390-2712

Mailing address

6689 Orchard Lake Rd # 308
West Bloomfield, MI 48322-3404
Phone (248) 539-0200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20050317000620 MI Practitioner - Psychiatry 4486637279 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Michigan Medical School, 1965
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Physician GroupGroup PAC ID 8628087681, 399 clinicians

Practice addresses (Care Compare)

3901 Chrysler Dr
Suite 1a
Detroit, MI 48201-2167
Phone (313) 993-3964

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301027031MIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stuart S. Segal, PH.D., PLLC CurrentSince Jan 19, 2025 Accepting new patients
University Physician Group CurrentSince Jun 22, 2022 Accepting new patients
Psychopharmacology Associates PC CurrentSince Jan 6, 1997 Accepting new patients
University Physician Group Past Accepting new patients

Locations

3901 Chrysler Dr
Ste 1A
Detroit, MI 48201
Phone (313) 577-1396

3901 Chrysler Dr
Ste 3B
Detroit, MI 48201
Phone (313) 577-1396

4100 John R St
Detroit, MI 48201
Phone (313) 576-8530

30095 Northwestern Hwy
Ste 20A
Farmington Hills, MI 48334
Phone (248) 579-5752

1560 E Maple Rd
Ste 200
Troy, MI 48083
Phone (248) 581-5200

Interoperability endpoints

  • Direct secure messaging: alan.rosenbaum.1@19711.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.

NPI Registry JSON

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700092800000",
    "number": "1629042528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6689 ORCHARD LAKE RD # 308",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223404",
            "telephone_number": "248-539-0200",
            "fax_number": "248-539-0987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2619 KINGSTOWNE DR",
            "city": "COMMERCE TWP",
            "state": "MI",
            "postal_code": "483902712",
            "telephone_number": "248-539-0200",
            "fax_number": "248-539-0987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBAUM",
        "first_name": "ALAN",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2023-11-16",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301027031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Commerce TWP, MI

Sources for this page

Verify at the official NPI Registry.