NPIMap

Individual provider Active NPI

Gregory D Rosen, M.D.

  • Emergency Medicine Physician
  • Pleasant Prairie, WI
National Provider Identifier
1720300411
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036125035 Issued in IL
Practice address
9555 76TH St
Pleasant Prairie, WI 53158-1984
Phone
(262) 577-8202
NPI assigned
Feb 22, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 60636 WI
Emergency Medicine Physician 207P00000X 036125035 IL Primary

Addresses

Primary practice location

9555 76TH St
Pleasant Prairie, WI 53158-1984

Mailing address

4305 Walters Ave
Northbrook, IL 60062-2925
Phone (847) 772-1562

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20101111000010 IL Practitioner - Emergency Medicine 0840485223 Reassigns benefits to 2 organizations
I20130617000353 WI Practitioner - Emergency Medicine 0840485223 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cepamerica Illinois LLPGroup PAC ID 3274793633, 492 clinicians
Vituity-Wisconsin Em SCGroup PAC ID 2466814538, 56 clinicians

Practice addresses (Care Compare)

801 S Milwaukee Ave
Libertyville, IL 60048-3204
Phone (847) 990-5300

9555 76TH St
Pleasant Prairie, WI 53158-1984
Phone (262) 577-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.74 of 100Reported as group
Quality
73.23
Improvement activities
40
Cost
82.42

Merit-based Incentive Payment System (MIPS)

Final score
93.41 of 100Reported as group
Quality
86.81
Improvement activities
40
Cost
77.34

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60636WIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community First Healthcare of Illinois, Inc. CurrentSince Dec 1, 2016 Accepting new patients
Cep America - Illinois, LLP Emergency Medicine CurrentSince Dec 22, 2022 Accepting new patients
Cepamerica Illinois LLP Emergency Medicine CurrentSince Dec 22, 2022 Accepting new patients
Community First Healthcare of Illinois, Inc. Emergency Medicine Current Accepting new patients
Community First Healthcare of Illinois, Inc. CurrentSince Dec 1, 2016 Accepting new patients
Vituity-Wisconsin Em SC Emergency Medicine CurrentSince Aug 15, 2023 Accepting new patients
Cepamerica Illinois LLP Emergency Medicine Current Accepting new patients
Vituity-Wisconsin Em SC Emergency Medicine CurrentSince Aug 15, 2023 Accepting new patients
United Occupational Medicine and Walk in Services, LLC Emergency Medicine Past Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

5645 W Addison St
Chicago, IL 60634
Phone (773) 282-7000

1425 N Randall Rd
Elgin, IL 60123
Phone (224) 783-5437

355 Ridge Ave
Evanston, IL 60202
Phone (847) 316-2329

801 S Milwaukee Ave
Libertyville, IL 60048
Phone (847) 362-2900

9555 76th St
Pleasant Prairie, WI 53158
Phone (262) 577-8000

Organizations & group practices 9

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1266796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1720300411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4305 WALTERS AVE",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622925",
            "telephone_number": "847-772-1562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9555 76TH ST",
            "city": "PLEASANT PRAIRIE",
            "state": "WI",
            "postal_code": "531581984",
            "telephone_number": "262-577-8202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEN",
        "first_name": "GREGORY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-02-22",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "60636",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036125035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasant Prairie, WI

Sources for this page

Verify at the official NPI Registry.