Active NPI
Jessica Brianna Rosenfeld, PSYD
- Psychologist
- Eugene, OR
National Provider Identifier
1629476734
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 3134
- Practice address
- 66 Club Rd Ste 120
Eugene, OR 97401-2439 - Phone
- (541) 393-5983
- NPI assigned
- Dec 5, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Psychologist | 103T00000X | 3134 | OR | Primary |
Addresses
Primary practice location
66 Club Rd Ste 120
Eugene, OR 97401-2439
Mailing address
66 Club Rd Ste 120
Eugene, OR 97401-2439
Phone (541) 393-5983
Other practice location 1
2450 S Vine St
Denver, CO 80210-5264
Phone (303) 871-4004
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500768821 | Medicaid | OR |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | www.strongibh.com | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in HI
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240910002207 | HI | Practitioner - Clinical Psychologist | 5991036139 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3134 | OR | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1417737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580688000000",
"number": "1629476734",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "66 CLUB RD STE 120",
"city": "EUGENE",
"state": "OR",
"postal_code": "974012439",
"telephone_number": "541-393-5983"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "66 CLUB RD STE 120",
"city": "EUGENE",
"state": "OR",
"postal_code": "974012439",
"telephone_number": "541-393-5983"
}
],
"practiceLocations": [
{
"address_1": "2450 S Vine St",
"address_purpose": "LOCATION",
"city": "Denver",
"state": "CO",
"postal_code": "802105264",
"country_code": "US",
"telephone_number": "303-871-4004",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROSENFELD",
"first_name": "JESSICA",
"middle_name": "BRIANNA",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-12-05",
"last_updated": "2020-02-03",
"certification_date": "2020-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "OR",
"license": "3134",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500768821",
"state": "OR"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "www.strongibh.com",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "66 Club Rd Ste 120",
"city": "Eugene",
"state": "OR",
"country_code": "US",
"postal_code": "974012439",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Eugene, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.