Individual provider Active NPI

Allen Edwin Rosen, MD

  • Pulmonary Disease Physician
  • Riviera Beach, FL
National Provider Identifier
1710989140
Registry record updated Mar 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
ME0032989 Issued in FL
Practice address
5555 W Blue Heron Blvd
Riviera Beach, FL 33418-7813
Phone
(561) 659-1000
Fax
(561) 659-1009
NPI assigned
Aug 15, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X ME0032989 FL Primary

Addresses

Primary practice location

5555 W Blue Heron Blvd
Riviera Beach, FL 33418-7813

Mailing address

17 Sheldrake LN
Palm Beach Gardens, FL 33418-6831
Phone (561) 659-1000

Other identifiers 1

IdentifierTypeStateIssuer
067314500MedicaidFL

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100928000145 FL Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 6608992680 Practice locations: Mangonia Park, FL; Riviera Beach, FL; West Palm Beach, FL

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0032989FLMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allen Rosen, M.D. Pulmonary Disease PastSince Jan 1, 1978 Accepting new patients

Organizations & group practices 1

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": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425427200000",
    "number": "1710989140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 SHELDRAKE LN",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334186831",
            "telephone_number": "561-659-1000",
            "fax_number": "561-659-1009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 W BLUE HERON BLVD",
            "city": "RIVIERA BEACH",
            "state": "FL",
            "postal_code": "334187813",
            "telephone_number": "561-659-1000",
            "fax_number": "561-659-1009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEN",
        "first_name": "ALLEN",
        "middle_name": "EDWIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2015-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "ME0032989",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "067314500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riviera Beach, FL

Sources for this page

Verify at the official NPI Registry.