Individual provider Active NPI

Richard Anthony Rose, D.P.M.

  • Podiatrist
  • Fairfield, IA
National Provider Identifier
1790775922
Registry record updated Oct 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
688 Issued in IA
Practice address
202 E Briggs Ave
Fairfield, IA 52556-2925
Phone
(641) 472-9731
Fax
(641) 472-9589
NPI assigned
Oct 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 688 IA Primary

Addresses

Primary practice location

202 E Briggs Ave
Fairfield, IA 52556-2925

Mailing address

PO Box 1687
Fairfield, IA 52556-0029
Phone (641) 472-9371

Other identifiers 3

IdentifierTypeStateIssuer
8970OtherMIDLAND'S CHOICE
0151696MedicaidIA
58773OtherIABC / BS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050609000518 IA Practitioner - Podiatry 1355384447 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
College of Podiatric Med and Surgery, Des Moines University, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

202 E Briggs Ave
Fairfield, IA 52556-2925
Phone (641) 472-9371

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue18
Removal of nail tissue711
Removal or shaving of skin growth101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00688IAMDOccupational Therapist
688IAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rose Foot Clinic PC Podiatrist CurrentSince Apr 1, 1997 Accepting new patients

Locations

202 E Briggs Ave
Fairfield, IA 52556
Phone (641) 472-9371

Interoperability endpoints

  • Direct secure messaging: rrose87881@uihcdirect.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222905600000",
    "number": "1790775922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1687",
            "city": "FAIRFIELD",
            "state": "IA",
            "postal_code": "525560029",
            "telephone_number": "641-472-9371",
            "fax_number": "641-472-9589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 E BRIGGS AVE",
            "city": "FAIRFIELD",
            "state": "IA",
            "postal_code": "525562925",
            "telephone_number": "641-472-9731",
            "fax_number": "641-472-9589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "RICHARD",
        "middle_name": "ANTHONY",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-27",
        "last_updated": "2008-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IA",
            "license": "688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLAND'S CHOICE",
            "identifier": "8970",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0151696",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC / BS",
            "identifier": "58773",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, IA

Sources for this page

Verify at the official NPI Registry.