NPIMap

Individual provider Active NPI

Ilyse Shara Rosenberg, DO

  • Psychiatry Physician
  • Bellevue, WA
National Provider Identifier
1649430125
Registry record updated Oct 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
247618 Issued in NY
Practice address
14205 SE 36TH St Ste 100
Bellevue, WA 98006-1553
Phone
(425) 657-8819
Fax
(651) 379-1740
NPI assigned
Jun 10, 2008
Last updated
Oct 24, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 247618 NY Primary

Addresses

Primary practice location

14205 SE 36TH St Ste 100
Bellevue, WA 98006-1553

Mailing address

14205 SE 36TH St Ste 100
Bellevue, WA 98006-1553
Phone (425) 519-3617

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Previously, effective Oct 1, 2024 through Oct 1, 2026

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Psychiatry Current Accepting new patients
Jewish Board for Family and Children Services Past Accepting new patients
Catholic Charities Neighborhood Services, Inc. Past Accepting new patients
Catholic Charities Neigborhood Services Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ilyserosenberg@tdh.allscriptsdirect.net

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, 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": "1213056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571875200000",
    "number": "1649430125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14205 SE 36TH ST STE 100",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980061553",
            "telephone_number": "425-519-3617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14205 SE 36TH ST STE 100",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980061553",
            "telephone_number": "425-657-8819",
            "fax_number": "651-379-1740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBERG",
        "first_name": "ILYSE",
        "middle_name": "SHARA",
        "name_prefix": "Mrs.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-10",
        "last_updated": "2019-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "247618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.