Active NPI
Randy Rosenberg, MD
- Neurology Physician
- Philadelphia, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- MD016929E
- Practice address
- 3509 N Broad St
Philadelphia, PA 19140-4105 - Phone
- (215) 707-3040
- Fax
- (215) 707-8235
- NPI assigned
- Jun 1, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | MD016929E | PA | |
| Neurology Physician | 2084N0400X | MD016929E | PA | Primary |
Addresses
Primary practice location
3509 N Broad St
Philadelphia, PA 19140-4105
Mailing address
2450 W Hunting Park Ave
Philadelphia, PA 19129-1302
Phone (215) 707-3040
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01108143 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD016929E | PA | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Temple Faculty Practice Plan, Inc | Current | Accepting new patients | |
| Temple Faculty Practice Plan Inc | Current | Accepting new patients | |
| Temple Faculty Practice Plan Inc | Current | Accepting new patients |
Locations
515 Pennsylvania Ave
Ft Washington, PA 19034
Phone (215) 641-0700
3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807
7604 Central Ave
Philadelphia, PA 19111
Phone (215) 745-3400
333 Cottman Ave
Philadelphia, PA 19111
Phone (215) 728-3893
8815 Germantown Ave
Philadelphia, PA 19118
Phone (215) 248-8145
3509 N Broad St
Philadelphia, PA 19140
Phone (215) 707-2433
2450 W Hunting Park Ave
Philadelphia, PA 19129
Phone (215) 707-2433
Organizations & group practices 3
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.
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-
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- Voorhees, NJ
- NPI 1407638794
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423094400000",
"number": "1679510283",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2450 W HUNTING PARK AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191291302",
"telephone_number": "215-707-3040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3509 N BROAD ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191404105",
"telephone_number": "215-707-3040",
"fax_number": "215-707-8235"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSENBERG",
"first_name": "RANDY",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-01",
"last_updated": "2015-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "PA",
"license": "MD016929E",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "PA",
"license": "MD016929E",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01108143",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2015; 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.