Matthew Henry Rosa, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

243698-1 Issued in NY

Practice address

7030 E Genesee St
Suite 109
Fayetteville, NY 13066-1121

Phone

(315) 510-6760

Fax

(315) 446-7521

NPI assigned

May 22, 2007

Last updated

Aug 21, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 23, 2017 through Jan 23, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Consultation Services of Central New York - Medicine Provider, PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fayetteville, NY
  • NPI 1205089992
  NPD (past) Authorized official

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408579200000",
    "number": "1780893792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7030 E GENESEE ST",
            "address_2": "SUITE 109",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130661121",
            "telephone_number": "315-510-6760",
            "fax_number": "315-446-7521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7030 E GENESEE ST",
            "address_2": "SUITE 109",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130661121",
            "telephone_number": "315-510-6760",
            "fax_number": "315-446-7521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSA",
        "first_name": "MATTHEW",
        "middle_name": "HENRY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2014-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "2005-01928",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "243698-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward Robison, D.D.S.
• Sonja Rockett, OTR
• Gerard S Rodziewicz, MD
• Melissa Roe, PA
• Ronald S D'Amico DPM
• Suzzanne C Rosselot, LCSW
• Stephen Jay Rothenberg, DDS
• Melissa A Rothfeld, PT
• Marenea R Roule, CRNA
• Rochele Royster, ATR-BC

• Psychiatry Physician in Fayetteville, NY
• Providers in Fayetteville, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2014; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.