Robert M Rose, M.D.
Individual provider Active NPI Family Medicine Physician · King William, VA
NPI 1730527342 · NPPES record last updated Oct 31, 2016
Key facts
- NPI
- 1730527342
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 0101259659 (VA)
- Practice address
- 1041 Sharon Rd Ste 205
King William, VA 23086-3344 - Phone
- (804) 769-3096
- Fax
- (804) 769-3170
- NPI assigned
- Jun 6, 2013
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 16
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
7229 Forest Ave
Suite 112
Richmond, VA 23226-3765
Hospital & facility affiliations
- Brookside Home Health, an Amedisys Company
- Nayar Health Care LLC
- Accentcare Home Health of Virginia
- Riverside Home Health
- James River Home Health Agency
- Bon Secours Memorial Regional Medical Center
- Bon Secours St Marys Hospital
- Bon Secours Richmond Community Hospital
- Vcu Health Tappahannock Hospital
- Henrico Doctors' Hospital
- Sheltering Arms Institute
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160816002747 | VA | Practitioner - Family Practice | 4981999885 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101259659 | VA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bon Secours Memorial Regional Medical Center LLC | Family Medicine | Current |
Accepting new patients |
| Bon Secours Memorial Regional Medical Center LLC | Current | Accepting new patients | |
| Bon Secours - Memorial Regional Medical Center, Inc. | Current |
Accepting new patients | |
| Bon Secours Memorial Regional Medical Center LLC | Past | Accepting new patients |
Locations
1041 Sharon Rd
Ste 205
King William, VA 23086
Phone (804) 746-1677
4630 S Laburnum Ave
Richmond, VA 23231
Phone (804) 226-2444
Interoperability endpoints
- rrose1155199@direct.bsmhealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 0101259659 | VA | Yes |
Addresses
Primary practice location
1041 Sharon Rd Ste 205
King William, VA 23086-3344
Mailing address
1041 Sharon Rd Ste 205
King William, VA 23086-3344
Phone (804) 769-3096
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C05698 | Other | VA | GROUP PTAN |
Other providers in King William, VA
- Philip Mitchell
- Pamunkey Indian Tribe
- Wendy G Phillips
- Morgan Plowman
- Tiffany E Polo
- Kristen Russell
- Kristine Shafer
- Sleep Medix, Inc.
- Jill S Storment
- Megan Szorc
All providers in King William, VA · Family Medicine Physician in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 31, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.