Individual provider Active NPI

Wilfredo Go Rosell, M.D.

  • Internal Medicine Physician
  • Saranac Lake, NY
National Provider Identifier
1780842674
Registry record updated Dec 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
255195-1 Issued in NY
Practice address
33 Depot St
Saranac Lake, NY 12983-1497
Phone
(518) 626-5237
NPI assigned
May 28, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 255195-1 NY Primary

Addresses

Primary practice location

33 Depot St
Saranac Lake, NY 12983-1497

Mailing address

33 Depot St
Saranac Lake, NY 12983-1497
Phone (518) 626-5237

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20190208002880 NY Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 2163693961

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
255195-1NYMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1211932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481068800000",
    "number": "1780842674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 DEPOT ST",
            "city": "SARANAC LAKE",
            "state": "NY",
            "postal_code": "129831497",
            "telephone_number": "518-626-5237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 DEPOT ST",
            "city": "SARANAC LAKE",
            "state": "NY",
            "postal_code": "129831497",
            "telephone_number": "518-626-5237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSELL",
        "first_name": "WILFREDO",
        "middle_name": "GO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-28",
        "last_updated": "2016-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "255195-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saranac Lake, NY

Sources for this page

Verify at the official NPI Registry.