Marni B Rosen, PSY.D ATR

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071008588 Issued in IL

Practice address

2130 Green Bay Rd
Evanston, IL 60201-3026

Phone

(847) 425-9708

NPI assigned

Apr 16, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Clinical Psychologist

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Midwest Refuah Health CenterGroup PAC ID 5193103653, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JCEHCD

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.

• Midwest Refuah Health Center

  • Clinic/Center
  • Chicago, IL
  • NPI 1518601004
  Medicare reassignment Care Compare group NPD
• Midwest Refuah Health Center

  • Radiology Clinic/Center
  • Chicago, IL
  • NPI 1962219691
  NPD
• Behavorial Health Associates LTD

  • Adult Development & Aging Psychologist
  • Chicago, IL
  • NPI 1215153853
  NPD (past)
• Institute for Therapy Through the Arts

  • Adolescent and Children Mental Health Clinic/Center
  • Evanston, IL
  • NPI 1154708899

  Clinical

  NPD (past)
• Midwest Refuah Health Center

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1003622101

  Clinical

  NPD (past)

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

{
    "created_epoch": "1366070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1710320080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4235 BIRCHWOOD AVE",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600763860",
            "telephone_number": "646-831-9165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 GREEN BAY RD",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602013026",
            "telephone_number": "847-425-9708"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8 S Michigan Ave",
            "address_2": "Ste. 1203",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606033357",
            "country_code": "US",
            "telephone_number": "847-979-0132",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSEN",
        "first_name": "MARNI",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "PSY.D ATR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-16",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071008588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gina Lynne Roppolo-Osborne, CNP
• Gladys Lily Rosas, DPT
• Mallory Cooper Rose
• Benjamin Victor Rosen, PH.D.
• Claudia Rosen, M.S.W,, L.C.S.W
• Steve Rosen
• Jonathan Reuben Rosenberg, MD
• Julie Anne Rosenberg, MPT
• Michael Rosenberg, M.D.
• Rebecca Jo Rosenberg, LCSW

• Clinical Psychologist in Evanston, IL
• Providers in Evanston, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.