NPIMap

Individual provider Active NPI

Victoria Summer Rose, M.D.

  • Family Medicine Physician
  • Rio Grande, NJ
National Provider Identifier
1629338231
Registry record updated Jul 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA10581300 Issued in NJ
Practice address
1613 Route 47 Unit G
Rio Grande, NJ 08242
Phone
(609) 886-5245
Fax
(609) 886-5873
NPI assigned
May 17, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD453908 PA
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 25MA10581300 NJ Primary

Addresses

Primary practice location

1613 Route 47 Unit G
Rio Grande, NJ 08242

Mailing address

1613 Route 47 Unit G
Rio Grande, NJ 08242-1411
Phone (609) 886-5245

Other practice location 1

Highway 191 and Hospital Road
Chinle, AZ 86503
Phone (928) 674-7166

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190807000619 NJ Practitioner - Family Practice 6800028184 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Jefferson Medical College of Thomas Jefferson University, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Atlanticare Physician Group PAGroup PAC ID 8527953660, 506 clinicians

Practice addresses (Care Compare)

1613 Route 47
Unit F
Rio Grande, NJ 08242-1411
Phone (609) 407-2273

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA10581300NJMDFamily Medicine Physician
MD453908PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanticare Physician Group PA Family Medicine Current Accepting new patients
Atlanticare Physician Group, PA CurrentSince Jun 11, 2019 Accepting new patients
Atlanticare Physician Group CurrentSince Jun 11, 2019 Accepting new patients
Atlanticare Physician Group Past Accepting new patients
Cooper University Hospital Cape Regional Inc Past Accepting new patients

Locations

1925 Pacific Ave
Atlantic City, NJ 08401
Phone (609) 441-8023

6550 Delilah Rd
Ste 301
Egg Hbr Twp, NJ 08234
Phone (609) 573-1251

459 Route 9 S
Little Egg Harbor Twp, NJ 08087
Phone (609) 340-7815

1613 Route 47 S
Unit F
Rio Grande, NJ 08242
Phone (609) 886-5245

Organizations & group practices 5

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 6

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": "1337212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562025600000",
    "number": "1629338231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1613 ROUTE 47 UNIT G",
            "city": "RIO GRANDE",
            "state": "NJ",
            "postal_code": "082421411",
            "telephone_number": "609-886-5245",
            "fax_number": "609-886-5873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1613 ROUTE 47 UNIT G",
            "city": "RIO GRANDE",
            "state": "NJ",
            "postal_code": "08242",
            "telephone_number": "609-886-5245",
            "fax_number": "609-886-5873"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Highway 191 and Hospital Road",
            "address_purpose": "LOCATION",
            "city": "Chinle",
            "state": "AZ",
            "postal_code": "86503",
            "country_code": "US",
            "telephone_number": "928-674-7166",
            "fax_number": "928-674-7705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSE",
        "first_name": "VICTORIA",
        "middle_name": "SUMMER",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-17",
        "last_updated": "2019-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD453908",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA10581300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Grande, NJ

Sources for this page

Verify at the official NPI Registry.