Active NPI
Marylyn A Rosencranz, D.O.
- Diagnostic Radiology Physician
- Crown Point, IN
National Provider Identifier
1811981970
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 02001008
- Practice address
- 5363 Commerce Dr
Crown Point, IN 46307-5325 - Phone
- (219) 769-5000
- Fax
- (574) 273-1137
- NPI assigned
- Sep 6, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 02001008 | IN | Primary |
Addresses
Primary practice location
5363 Commerce Dr
Crown Point, IN 46307-5325
Mailing address
5363 Commerce Dr
Crown Point, IN 46307-5325
Phone (219) 769-5000
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200288940 | Medicaid | IN | |
| P00719157 | Other | IN | RAIL ROAD CARE |
| 000000576548 | Other | IN | ANTHEM |
| 036064791 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 02001008 | IN | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Indianapolis Breast Center, PC | Diagnostic Radiology | Past | Accepting new patients |
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.
-
- Diagnostic Radiology Physician
- Indianapolis, IN
- NPI 1154364495
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1355443200000",
"number": "1811981970",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5363 COMMERCE DR",
"city": "CROWN POINT",
"state": "IN",
"postal_code": "463075325",
"telephone_number": "219-769-5000",
"fax_number": "574-273-1137"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5363 COMMERCE DR",
"city": "CROWN POINT",
"state": "IN",
"postal_code": "463075325",
"telephone_number": "219-769-5000",
"fax_number": "574-273-1137"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSENCRANZ",
"first_name": "MARYLYN",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-06",
"last_updated": "2012-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "IN",
"license": "02001008",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200288940",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAIL ROAD CARE",
"identifier": "P00719157",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000576548",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036064791",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Crown Point, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.