Individual provider Active NPI

Beth Nancy Rosen, PH.D.

  • Psychologist
  • Crestview Hills, KY
National Provider Identifier
1649378258
Registry record updated Aug 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
175058 Issued in KY
Practice address
334 Thomas More Pkwy
Crestview Hills, KY 41017
Phone
(859) 301-5901
Fax
(859) 301-5940
NPI assigned
Sep 20, 2006
Last updated
Aug 30, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PS00608 RI
Psychologist 103T00000X 6311 MA
Psychologist 103T00000X 175058 KY Primary

Addresses

Primary practice location

334 Thomas More Pkwy
Crestview Hills, KY 41017

Mailing address

PO Box 635283
Cincinnati, OH 45263-5283
Phone (859) 301-5901

Other practice location 1

275 Turnpike St
Suite 105
Canton, MA 02021-2357
Phone (781) 828-7645 ext. 4

Other identifiers 2

IdentifierTypeStateIssuer
7100512140MedicaidKY
K260920OtherKYKY MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180309002114 KY Practitioner - Clinical Psychologist 1456345735 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Summit Medical Group IncGroup PAC ID 2163326240, 803 clinicians

Practice addresses (Care Compare)

1400 Grand Ave
Newport, KY 41071-2570
Phone (859) 912-7193

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PS00608RIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, Inc. CurrentSince Mar 15, 2018 Accepting new patients
Summit Medical Group, Inc Psychologist CurrentSince Mar 15, 2018 Accepting new patients
Psychological Associates of Southeastern Massachusetts, LLC PastSince Feb 1, 2012 Accepting new patients
Child and Family Psychological Services, PLLC Psychologist Past Accepting new patients

Locations

334 Thomas More Pkwy
Crestview Hills, KY 41017
Phone (859) 331-6065

1980 Litton Ln
Hebron, KY 41048
Phone (859) 334-8700

1400 Grand Ave
Newport, KY 41071
Phone (859) 905-3070

300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217

Interoperability endpoints

  • Direct secure messaging: brosen217484@direct-prd.stelizabeth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535587200000",
    "number": "1649378258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635283",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452635283",
            "telephone_number": "859-301-5901",
            "fax_number": "859-301-5940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "334 THOMAS MORE PKWY",
            "city": "CRESTVIEW HILLS",
            "state": "KY",
            "postal_code": "41017",
            "telephone_number": "859-301-5901",
            "fax_number": "859-301-5940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "275 Turnpike St",
            "address_2": "Suite 105",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "MA",
            "postal_code": "020212357",
            "country_code": "US",
            "telephone_number": "781-828-7645 x4",
            "fax_number": "781-821-1743",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSEN",
        "first_name": "BETH",
        "middle_name": "NANCY",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2018-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "RI",
            "license": "PS00608",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "6311",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "KY",
            "license": "175058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100512140",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KY MEDICARE",
            "identifier": "K260920",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crestview Hills, KY

Sources for this page

Verify at the official NPI Registry.