Individual provider Active NPI

Elena Rosenbaum, M.D.

  • Family Medicine Physician
  • Halfmoon, NY
National Provider Identifier
1689797607
Registry record updated May 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
248307 Issued in NY
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

Updated by the provider on May 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
03023627MedicaidNY

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080805000090 NY Practitioner - Family Practice 1153421912 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Whitney M. Young Jr. Health Center, Inc. CurrentSince Apr 24, 2024 Accepting new patients
Whitney M Young Jr Health Center Inc CurrentSince Apr 24, 2024 Accepting new patients
Community Care Physicians, PLLC Family Medicine CurrentSince Aug 1, 2008 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

  • Direct secure messaging: erosenbaum29003@albanymed.direct-ci.com
  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.