Individual provider Active NPI

Matt Toren Rosenberg, M.D.

  • Family Medicine Physician
  • Jackson, MI
National Provider Identifier
1730289711
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301065227 Issued in MI
Practice address
214 N West Ave
Jackson, MI 49201-1903
Phone
(517) 784-9189
NPI assigned
Sep 22, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301065227 MI Primary

Addresses

Primary practice location

214 N West Ave
Jackson, MI 49201-1903

Mailing address

214 N West Ave
Jackson, MI 49201-1903
Phone (517) 784-9189

Other identifiers 1

IdentifierTypeStateIssuer
3388781MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20040812000609 MI Practitioner - Family PracticePractitioner - Emergency Medicine 9739150111 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
University of California, Irvine, California College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Matt T Rosenberg PCGroup PAC ID 6507837986, 3 clinicians

Practice addresses (Care Compare)

214 N W Ave
Jackson, MI 49201-1903
Phone (517) 784-9189

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301065227MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Matt T Rosenberg PC Family Medicine CurrentSince Sep 1, 1996 Accepting new patients

Locations

214 N West Ave
Jackson, MI 49201
Phone (517) 784-9189

Interoperability endpoints

  • Direct secure messaging: mrosenberg462829@direct.hfhs.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730289711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 N WEST AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011903",
            "telephone_number": "517-784-9189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 N WEST AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011903",
            "telephone_number": "517-784-9189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBERG",
        "first_name": "MATT",
        "middle_name": "TOREN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301065227",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3388781",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.