Individual provider Active NPI

Aliza Naomi Rosen, PSY.D.

  • Clinical Psychologist
  • Melbourne, FL
National Provider Identifier
1700970662
Registry record updated Feb 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY6029 Issued in FL
Practice address
1370 Bedford Dr Ste 102
Melbourne, FL 32940-1993
Phone
(321) 757-7957
Fax
(321) 265-4015
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY6029 FL Primary

Addresses

Primary practice location

1370 Bedford Dr Ste 102
Melbourne, FL 32940-1993

Mailing address

1370 Bedford Dr Ste 102
Melbourne, FL 32940-1993
Phone (321) 757-7957

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20050114000202 FL Practitioner - Clinical Psychologist 3476502790 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

6767 N Wickham Rd
Suite 306
Melbourne, FL 32940-2025
Phone (321) 757-7957

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aliza Rosen, Psy.D.,P.a. Clinical CurrentSince Oct 1, 2004 Accepting new patients
Baytree Behavioral Health PA PastSince Aug 29, 2013 Accepting new patients

Locations

6767 N Wickham Rd
Ste 306
Melbourne, FL 32940
Phone (321) 751-1925

1370 Bedford Dr
Ste 106
Melbourne, FL 32940
Phone (321) 253-8887

1370 Bedford Dr
Ste 102
Melbourne, FL 32940
Phone (321) 622-8104

850 Garden St
Titusville, FL 32796
Phone (321) 267-3233

Organizations & group practices 2

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582156800000",
    "number": "1700970662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1370 BEDFORD DR STE 102",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329401993",
            "telephone_number": "321-757-7957",
            "fax_number": "321-253-8878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1370 BEDFORD DR STE 102",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329401993",
            "telephone_number": "321-757-7957",
            "fax_number": "321-265-4015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEN",
        "first_name": "ALIZA",
        "middle_name": "NAOMI",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY6029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.