Active NPI
Mark David Rostash
- Gerontology Nurse Practitioner
- Lebanon, NH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- 116942-23
- Practice address
- 1 Medical Center Dr
Lebanon, NH 03756-0001 - Phone
- (603) 650-5000
- NPI assigned
- Dec 17, 2019
- Last updated
- Sep 10, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | 235645 | AZ | |
| Acute Care Nurse Practitioner | 363LA2100X | APRN-3542 | HI | |
| Critical Care Medicine Nurse Practitioner | 363LC0200X | 235645 | AZ | |
| Gerontology Nurse Practitioner | 363LG0600X | 116942-23 | NH | Primary |
Addresses
Primary practice location
1 Medical Center Dr
Lebanon, NH 03756-0001
Mailing address
PO Box 810
Hanover, NH 03755-0810
Phone (603) 308-1467
Other practice location 1
5301 E Grant Rd
Tucson, AZ 85712-2805
Phone (520) 324-5461
Other practice location 2
1301 Punchbowl St
Honolulu, HI 96813-2499
Phone (808) 691-1000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 092349 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ, HI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1301 Punchbowl St
Honolulu, HI 96813-2499
1380 Lusitana St
Honolulu, HI 96813-2448
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN-3542 | HI | MD | Acute Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tucson Medical Center | Current | Accepting new patients | |
| The Queens Medical Center | Current | Accepting new patients | |
| The Queen's Medical Center | Current | Accepting new patients | |
| TMC Medical Network | Current | Accepting new patients | |
| Queens University Medical Group | Current | Accepting new patients | |
| The Queens Medical Center | Current | Accepting new patients | |
| Sound Physicians Intensivists of Arizona, Inc | Nurse Practitioner | Current | Accepting new patients |
| Tucson Medical Center | Current | Accepting new patients | |
| John J Cogan MD Inc | Past | Accepting new patients | |
| Tucson Medical Center | Past | Accepting new patients |
Locations
1601 W Saint Marys Rd
Tucson, AZ 85745
Phone (520) 622-5833
2380 N Ferguson Ave
Ste 104
Tucson, AZ 85712
Phone (520) 324-1010
350 N Wilmot Rd
Tucson, AZ 85711
Phone (520) 873-3000
5301 E Grant Rd
Tucson, AZ 85712
Phone (520) 324-1344
1301 Punchbowl St
Honolulu, HI 96813
Phone (808) 538-9011
1380 Lusitana St
Ste 913
Honolulu, HI 96813
Phone (808) 691-8521
550 S Beretania St
Ste 404
Honolulu, HI 96813
Phone (808) 691-8897
Organizations & group practices 10
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.
-
- Multi-Specialty Clinic/Center
- Honolulu, HI
- NPI 1891441382
-
- Internal Medicine Physician
- Tucson, AZ
- NPI 1962944702
Nurse Practitioner
-
- General Acute Care Hospital
- Honolulu, HI
- NPI 1487693586
-
- Multi-Specialty Clinic/Center
- Tucson, AZ
- NPI 1750832283
-
- General Acute Care Hospital
- Tucson, AZ
- NPI 1174512792
-
- General Acute Care Hospital
- Honolulu, HI
- NPI 1184612764
-
dba Queen's Island Urgent Care
- Urgent Care Clinic/Center
- Aiea, HI
- NPI 1912541905
-
dba Tucson Medical Center Outpatient Pharmacy
- Community/Retail Pharmacy
- Tucson, AZ
- NPI 1972876563
-
- Interventional Cardiology Physician
- Honolulu, HI
- NPI 1396898557
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Honolulu, HI
- NPI 1184612764
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1576540800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788998400000",
"number": "1780222158",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 810",
"city": "HANOVER",
"state": "NH",
"postal_code": "037550810",
"telephone_number": "603-308-1467"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 MEDICAL CENTER DR",
"city": "LEBANON",
"state": "NH",
"postal_code": "037560001",
"telephone_number": "603-650-5000"
}
],
"practiceLocations": [
{
"address_1": "5301 E Grant Rd",
"address_purpose": "LOCATION",
"city": "Tucson",
"state": "AZ",
"postal_code": "857122805",
"country_code": "US",
"telephone_number": "520-324-5461",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1301 Punchbowl St",
"address_purpose": "LOCATION",
"city": "Honolulu",
"state": "HI",
"postal_code": "968132499",
"country_code": "US",
"telephone_number": "808-691-1000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROSTASH",
"first_name": "MARK",
"middle_name": "DAVID",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-12-17",
"last_updated": "2026-09-10",
"certification_date": "2026-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "AZ",
"license": "235645",
"primary": false
},
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "HI",
"license": "APRN-3542",
"primary": false
},
{
"code": "363LC0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Critical Care Medicine",
"state": "AZ",
"license": "235645",
"primary": false
},
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "NH",
"license": "116942-23",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "092349",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lebanon, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.