Individual provider Active NPI

Eric Daniel Rosenthal, M.D.

  • Emergency Medicine Physician
  • Rutland, VT
National Provider Identifier
1629244892
Registry record updated Nov 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
042-0011934 Issued in VT
Practice address
160 Allen St
Rutland Regional Medical Center- Emergency Medicine
Rutland, VT 05701-4560
Phone
(802) 747-3606
NPI assigned
May 7, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 042-0011934 VT Primary

Addresses

Primary practice location

160 Allen St
Rutland Regional Medical Center- Emergency Medicine
Rutland, VT 05701-4560

Mailing address

160 Allen St
Rutland Regional Medical Center- Emergency Medicine
Rutland, VT 05701-4560
Phone (802) 747-3606

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20140611001497 MN Practitioner - Emergency Medicine 7315131778 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
042-0011934VTMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Suburban Emergency Associates, P.a. Emergency Medicine CurrentSince Jul 1, 2014 Accepting new patients

Locations

303 Catlin St
Buffalo, MN 55313
Phone (763) 682-1212

1455 Saint Francis Ave
Shakopee, MN 55379
Phone (952) 403-2200

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": "1210118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290038400000",
    "number": "1629244892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 ALLEN ST",
            "address_2": "RUTLAND REGIONAL MEDICAL CENTER- EMERGENCY MEDICINE",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014560",
            "telephone_number": "802-747-3606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 ALLEN ST",
            "address_2": "RUTLAND REGIONAL MEDICAL CENTER- EMERGENCY MEDICINE",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014560",
            "telephone_number": "802-747-3606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENTHAL",
        "first_name": "ERIC",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-07",
        "last_updated": "2010-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VT",
            "license": "042-0011934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rutland, VT

Sources for this page

Verify at the official NPI Registry.