Individual provider Active NPI

Andrew R. Rosen, MD

  • Internal Medicine Physician
  • Londonderry, NH
National Provider Identifier
1629059613
Registry record updated Jul 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
11036 Issued in NH
Practice address
40 Buttrick Rd
Londonderry, NH 03053-3381
Phone
(603) 552-1400
Fax
(603) 552-1499
NPI assigned
Nov 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 11036 NH Primary
Pediatrics Physician 208000000X 11036 NH

Addresses

Primary practice location

40 Buttrick Rd
Londonderry, NH 03053-3381

Mailing address

40 Buttrick Rd
Londonderry, NH 03053-3381
Phone (603) 552-1400

Other identifiers 9

IdentifierTypeStateIssuer
H28507OtherNHANTHEM REFERRING UPIN
0442517OtherNHUHC PIN
532720OtherNHCIGNA PIN
2431036OtherNHAETNA PIN
30200904MedicaidNH
990015343OtherNHRR MEDICARE PIN
01YP02564NH01OtherNHANTHEM ACES PIN
N1930OtherNHHPHC PIN
011036OtherNHTUFTS PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20051206000940 NH Practitioner - Internal MedicinePractitioner - Pediatric Medicine 8022038959 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
University of Rochester School of Medicine and Dentistry, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Elliot Physicians NetworkGroup PAC ID 6406743988, 78 clinicians

Practice addresses (Care Compare)

275 Mammoth Rd
Manchester, NH 03109-4133

40 Butrrick Rd
Londonderry, NH 03053-3381
Phone (603) 434-1919

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11036NHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Elliot Professional Services Internal Medicine CurrentSince Sep 23, 2009 Accepting new patients
Elliot Physicians Network Internal Medicine CurrentSince Nov 16, 2000 Accepting new patients
Elliot Physicians Network Internal Medicine Past Accepting new patients

Locations

40 Buttrick Rd
Londonderry, NH 03053
Phone (603) 552-1400

40 Buttrick Rd
Ste 105
Londonderry, NH 03053

40 Buttrick Rd
#B
Londonderry, NH 03053

40 Buttrick Rd
Unit 1
Londonderry, NH 03053

275 Mammoth Rd
Manchester, NH 03109
Phone (603) 663-8300

275 Mammoth Rd
Ste 1
Manchester, NH 03109
Phone (603) 663-3222

1 Elliot Way
Manchester, NH 03103
Phone (603) 663-2271

18 Pelham Rd
Ste 1
Salem, NH 03079
Phone (603) 870-7400

Organizations & group practices 3

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 2

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": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184198400000",
    "number": "1629059613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 BUTTRICK RD",
            "city": "LONDONDERRY",
            "state": "NH",
            "postal_code": "030533381",
            "telephone_number": "603-552-1400",
            "fax_number": "603-552-1499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 BUTTRICK RD",
            "city": "LONDONDERRY",
            "state": "NH",
            "postal_code": "030533381",
            "telephone_number": "603-552-1400",
            "fax_number": "603-552-1499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEN",
        "first_name": "ANDREW",
        "middle_name": "R.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-08",
        "last_updated": "2007-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NH",
            "license": "11036",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NH",
            "license": "11036",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM REFERRING UPIN",
            "identifier": "H28507",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC PIN",
            "identifier": "0442517",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PIN",
            "identifier": "532720",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PIN",
            "identifier": "2431036",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30200904",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PIN",
            "identifier": "990015343",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM ACES PIN",
            "identifier": "01YP02564NH01",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HPHC PIN",
            "identifier": "N1930",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS PIN",
            "identifier": "011036",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Londonderry, NH

Sources for this page

Verify at the official NPI Registry.