NPIMap

Individual provider Active NPI

Stacy Lyn Rosenberg, M.D.

  • Pediatrics Physician
  • Hazle Township, PA
National Provider Identifier
1629364575
Registry record updated Aug 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MT199538 Issued in PA
Practice address
426 Airport Rd
Hazle Township, PA 18202-3361
Phone
(570) 459-9730
Fax
(570) 459-9736
NPI assigned
Jun 20, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MT199538 PA Primary

Addresses

Primary practice location

426 Airport Rd
Hazle Township, PA 18202-3361

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address srosenberg167011@direct.geisinger.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20161112000106 PA Practitioner - Allergy/ImmunologyPractitioner - Pediatric Medicine 0749569838 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Allergy/ImmunologyAlso: Pediatric Medicine
Education
Tulane University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

426 Airport Rd
Hazle Township, PA 18202-3361
Phone (570) 459-9730

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT199538PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Jul 2, 2018 Accepting new patients
Caring Community Health Center CurrentSince Nov 12, 2019 Accepting new patients
Caring Community Health Center CurrentSince Nov 12, 2019 Accepting new patients
Geisinger Clinic Current Accepting new patients
University of Pittsburgh Physicians CurrentSince Sep 20, 2016 Accepting new patients
University of Pittsburgh Physicians CurrentSince Sep 20, 2016 Accepting new patients
Caring Community Health Center Current Accepting new patients
University of Pittsburgh Physicians Current Accepting new patients
Geisinger Clinic CurrentSince Jul 2, 2018 Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

426 Airport Rd
Ste 125
Hazle Township, PA 18202
Phone (570) 829-2621

426 Airport Rd
Hazle Township, PA 18202
Phone (570) 453-0172

190 Welles St
Kingston, PA 18704
Phone (570) 283-0524

3459 5th Ave
#G
Pittsburgh, PA 15213
Phone (412) 648-6161

4401 Penn Ave
Pittsburgh, PA 15224
Phone (412) 692-5030

63 Pitt St
Ste 100
Sharon, PA 16146
Phone (724) 347-4596

Interoperability endpoints

  • Direct secure messaging: srosenberg167011@direct.geisinger.edu

Organizations & group practices 10

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 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1308528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598832000000",
    "number": "1629364575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "426 AIRPORT RD",
            "city": "HAZLE TOWNSHIP",
            "state": "PA",
            "postal_code": "182023361",
            "telephone_number": "570-459-9730",
            "fax_number": "570-459-9736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBERG",
        "first_name": "STACY",
        "middle_name": "LYN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-20",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MT199538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "srosenberg167011@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "426 Airport Rd",
            "city": "Hazle Township",
            "state": "PA",
            "country_code": "US",
            "postal_code": "182023361",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hazle Township, PA

Sources for this page

Verify at the official NPI Registry.