Kenneth M. Rose, M.D., PLLC

Primary specialty

PACE Provider OrganizationTaxonomy code 251T00000X

License

188699-1 Issued in NY

Legal business name

KENNETH M. ROSE, M.D., PLLC

Practice address

75 Central Park W
New York, NY 10023-6011

Phone

(212) 888-7773

Fax

(212) 421-7030

NPI assigned

Jun 22, 2009

Organization subpart

No

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

Authorized official

Name

Ms. Juanita Butler

Title

Office Manager

Phone

(212) 888-7773

Specialties & licenses 1

Addresses

Other names 1

• Kenneth M. Rose, M.D., PLLC Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Tax ID family

Kenneth M Rose MD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Kenneth M. Rose, M.D.,

  • Personal Emergency Response Attendant
  • New York, NY
  • NPI 1134596570
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kenneth M Rose Sr., MD

  • Plastic Surgery Physician
  • New York, NY
  • NPI 1710033584
  Medicare reassignment

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

{
    "created_epoch": "1245628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245628800000",
    "number": "1770711301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 CENTRAL PARK W",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100236011",
            "telephone_number": "212-888-7773",
            "fax_number": "212-421-7930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 CENTRAL PARK W",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100236011",
            "telephone_number": "212-888-7773",
            "fax_number": "212-421-7030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH M. ROSE, M.D., PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-22",
        "last_updated": "2009-06-22",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "JUANITA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "212-888-7773",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": "NY",
            "license": "188699-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kenneth M. Rose, M.D., PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kenneth C Vitale MD, P.C.
• Kenneth C. Tam, M.D., F.a.C.C., P.C.
• Kenneth Levey Medical PC
• Kenneth Liao, M.D. L.L.C.
• Kenneth M. Rose, M.D.,
• Kenneth Meisler DPM PLLC
• Kenneth Moskowitz DPM
• Kenneth Myers, LCSW, PLLC
• Kenneth P. Mueller, PHD
• Kenneth P. Scileppi, MD, PC

• PACE Provider Organization in New York, NY
• Providers in New York, NY by specialty
• PACE Provider Organization in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.