Jacqueline Rosenbaum, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

021349 Issued in NY

Practice address

123 Everett Rd
Albany, NY 12205-1407

Phone

(518) 701-2000

Fax

(518) 701-2139

NPI assigned

Sep 21, 2017

Sex

Female

Sole proprietor

No

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 NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Magnolia Dermatology, PLLCGroup PAC ID 8123560679, 4 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

87.76 of 100Reported as group

Quality

84.34

Promoting interoperability

99

Improvement activities

40

Cost

75.69

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: jacqueline.rosenbaum.d1.p1@direct.aent.nextgenshare.com

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.

• Magnolia Dermatology, PLLC

  • Dermatology Physician
  • Latham, NY
  • NPI 1932889102
  Medicare reassignment Care Compare group
• Albany ENT & Allergy Services PC

  • Otolaryngology Physician
  • Albany, NY
  • NPI 1205838729
  Medicare reassignment

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

{
    "created_epoch": "1505952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581120000000",
    "number": "1710496757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 EVERETT RD",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122051407",
            "telephone_number": "518-701-2000",
            "fax_number": "518-701-2139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 EVERETT RD",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122051407",
            "telephone_number": "518-701-2000",
            "fax_number": "518-701-2139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBAUM",
        "first_name": "JACQUELINE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-21",
        "last_updated": "2020-02-08",
        "certification_date": "2020-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "021349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diana J Rosen, LCSW
• Jessica Rosen, MD
• Rebecca Guerrette Rosen, SLP
• Andrew J Rosenbaum, M.D.
• Elyan Rosenbaum, LMHC
• Lily M Rosenberg, MS-PA
• Stuart A. Rosenberg, M.D.
• Michael J Rosenblum, MD
• Shari Rosenblum, PT
• Helena Rosenstrauch, M.A., CCC-SLP

• Surgical Physician Assistant in Albany, NY
• Providers in Albany, NY by specialty
• Surgical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 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.