Active NPI
Tamzin A Rosenwasser
- Dermatology Physician
- Lafayette, IN
National Provider Identifier
1720017361
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 01057228A
- Practice address
- 1500 Salem St
Lafayette, IN 47904-2164 - Phone
- (765) 448-8000
- NPI assigned
- Jul 3, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | ME71744 | FL | |
| Dermatology Physician | 207N00000X | 01057228A | IN | Primary |
Addresses
Primary practice location
1500 Salem St
Lafayette, IN 47904-2164
Mailing address
4411 Bee Ridge Road
PMB 309
Sarasota, FL 34233-5545
Phone (941) 926-6553
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200830950 | Medicaid | IN | |
| 9294464 | Other | IN | PHCS PID NUMBER |
| 000000487140 | Other | IN | ANTHEM PROVIDER NUMBER |
| HQ199Z | Other | FL | MEDICARE PTAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dartmouth-Hitchcock Clinic | Past | 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.
-
- Internal Medicine Physician
- Lebanon, NH
- NPI 1548210198
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602547200000",
"number": "1720017361",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4411 BEE RIDGE ROAD",
"address_2": "PMB 309",
"city": "SARASOTA",
"state": "FL",
"postal_code": "342335545",
"telephone_number": "941-926-6553"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 SALEM ST",
"city": "LAFAYETTE",
"state": "IN",
"postal_code": "479042164",
"telephone_number": "765-448-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSENWASSER",
"first_name": "TAMZIN",
"middle_name": "A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-03",
"last_updated": "2020-10-13",
"certification_date": "2020-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "FL",
"license": "ME71744",
"primary": false
},
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "IN",
"license": "01057228A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200830950",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHCS PID NUMBER",
"identifier": "9294464",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM PROVIDER NUMBER",
"identifier": "000000487140",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "HQ199Z",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lafayette, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.