Kenneth M Rose Sr., MD

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

188699 Issued in NY

Practice address

75 Central Park W
New York, NY 10023-6011

Phone

(212) 888-7773

Fax

(212) 421-7930

NPI assigned

Jan 26, 2007

Last updated

Jun 22, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: kmr9007@direct.nyp.org

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.

• Kenneth M. Rose, M.D., PLLC

  • PACE Provider Organization
  • New York, NY
  • NPI 1770711301
  Medicare reassignment
• Kenneth M. Rose, M.D.,

  • Personal Emergency Response Attendant
  • New York, NY
  • NPI 1134596570
  NPD
• Adam M. Mecinski M.D. LLC

  • Specialist
  • Frederick, MD
  • NPI 1003062449
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245628800000",
    "number": "1710033584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 CENTRAL PARK W",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100236011",
            "telephone_number": "212-888-7773",
            "fax_number": "212-421-7930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 CENTRAL PARK W",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100236011",
            "telephone_number": "212-888-7773",
            "fax_number": "212-421-7930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "KENNETH",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2009-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NY",
            "license": "188699",
            "primary": true
        },
        {
            "code": "2082S0105X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": "NY",
            "license": "188699",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "6015129",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "N28073",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01776865",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Clayton Rose, DO
• Julie S Rose, M.S., CCC-SLP
• Julien Rose, CNM,
• Katherine Rose
• Kathleen Rose, LCSW
• Kiley M Rose, LMSW
• Lauren Elizabeth Rose, M.A. CCC-SLP; TSHH
• Marisa Rose, MS, PT, SCS, ATC
• Mucella Rose, LMHC-D, LPC,M.A,ME.D
• Panumas Rose, RN

• Plastic Surgery Physician in New York, NY
• Providers in New York, NY by specialty
• Plastic Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2009; 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.

Verify at the official NPI Registry.