Active NPI
Elena Rosenbaum, M.D.
- Family Medicine Physician
- Halfmoon, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 248307
- Practice address
- 1714 Route 9 Ste a
Halfmoon, NY 12065-3111 - Phone
- (518) 900-1115
- NPI assigned
- Apr 6, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 248307 | NY | Primary |
Addresses
Primary practice location
1714 Route 9 Ste a
Halfmoon, NY 12065-3111
Mailing address
875 N High St Ste 200
Columbus, OH 43215-1429
Phone (518) 900-1115
Other practice location 1
391 Myrtle Avenue
Suite 4A
Albany, NY 12208
Phone (518) 207-2273
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03023627 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Whitney M. Young Jr. Health Center, Inc. | Current | Accepting new patients | |
| Whitney M Young Jr Health Center Inc | Current | Accepting new patients | |
| Community Care Physicians, PLLC | Family Medicine | Current | Accepting new patients |
| Whitney M. Young, Jr. Health Center, Inc. | Current | Accepting new patients | |
| Whitney M. Young Jr. Health Center, Inc. | Past | Accepting new patients | |
| Whitney M. Young, Jr. Health Center, Inc. | Past | Accepting new patients | |
| Community Care Physicians, PC | Past | Accepting new patients |
Locations
920 Lark Dr
Albany, NY 12207
Phone (518) 427-0102
391 Myrtle Ave
Ste 4A
Albany, NY 12208
Phone (518) 202-2273
711 Troy Schenectady Rd
Ste 203
Latham, NY 12110
Phone (518) 782-3742
711 Troy Schenectady Rd
Ste 210
Latham, NY 12110
6 Wellness Way
Ste 201
Latham, NY 12110
Phone (518) 782-3900
849 2nd Ave
Troy, NY 12182
Phone (518) 833-6900
Interoperability endpoints
- erosenbaum29003@albanymed.direct-ci.com
- elena.rosenbaum.1@22063.direct.athenahealth.com
Organizations & group practices 7
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.
-
- Internal Medicine Physician
- Latham, NY
- NPI 1922048370
Family Medicine
-
- Community Health Clinic/Center
- Albany, NY
- NPI 1417924762
-
- Community/Retail Pharmacy
- Albany, NY
- NPI 1982596870
-
- Community Health Clinic/Center
- Albany, NY
- NPI 1235537655
-
- Internal Medicine Physician
- Latham, NY
- NPI 1023380714
-
- Federally Qualified Health Center (FQHC)
- Albany, NY
- NPI 1942660105
-
- Federally Qualified Health Center (FQHC)
- Albany, NY
- NPI 1942573027
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651536000000",
"number": "1689797607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "875 N HIGH ST STE 200",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432151429",
"telephone_number": "518-900-1115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1714 ROUTE 9 STE A",
"city": "HALFMOON",
"state": "NY",
"postal_code": "120653111",
"telephone_number": "518-900-1115"
}
],
"practiceLocations": [
{
"address_1": "391 Myrtle Avenue",
"address_2": "Suite 4A",
"address_purpose": "LOCATION",
"city": "Albany",
"state": "NY",
"postal_code": "12208",
"country_code": "US",
"telephone_number": "518-207-2273",
"fax_number": "518-207-2293",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROSENBAUM",
"first_name": "ELENA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-06",
"last_updated": "2022-05-03",
"certification_date": "2022-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NY",
"license": "248307",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03023627",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Halfmoon, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2022; 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.