Paul Andrew Rozeboom, M.D.

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

32107 Issued in IA

Practice address

1 Jack Foster Dr
Shenandoah, IA 51601-4586

Phone

(712) 246-7400

Fax

(712) 246-7334

NPI assigned

Aug 23, 2005

Sex

Male

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 IA, TX2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: paulrozeboom@phs.ssdirect.aprima.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.

• Shenandoah Medical Center

  • Certified Registered Nurse Anesthetist
  • Shenandoah, IA
  • NPI 1497810972
  Medicare reassignment NPD
• Ponca Tribe of Nebraska

  • Clinic/Center
  • Omaha, NE
  • NPI 1710172879

  TX

  Medicare reassignment NPD
• Shenandoah Medical Center

  • Rural Health Clinic/Center
  • Shenandoah, IA
  • NPI 1427300201
  NPD
• Shenandoah Medical Center

  • Community/Retail Pharmacy
  • Shenandoah, IA
  • NPI 1447937230
  NPD

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489363200000",
    "number": "1730172040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PERSHING AVE",
            "city": "SHENANDOAH",
            "state": "IA",
            "postal_code": "516012355",
            "telephone_number": "712-246-1230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 JACK FOSTER DR",
            "city": "SHENANDOAH",
            "state": "IA",
            "postal_code": "516014586",
            "telephone_number": "712-246-7400",
            "fax_number": "712-246-7334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROZEBOOM",
        "first_name": "PAUL",
        "middle_name": "ANDREW",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2017-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "IA",
            "license": "32107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashlee Jo Richardson, PT, DPT
• Stephanie Robinette, ARNP
• Rebecca Judene Rose, MD
• Linda Rost, LMSW
• Brian Anthony Rowan, MD
• Michael Theodore Salwitz, MD
• Rebecca Ann Schaeffer, RN
• John Schleef, D.C.
• Alicia Pearl Schroder, PHARMD
• David W. Shane, L.C.S.W. (ILLINOIS)

• Pediatric Adolescent Medicine Physician in Shenandoah, IA
• Providers in Shenandoah, IA by specialty
• Pediatric Adolescent Medicine Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.