Max Paul Rosen, MD MPH
Individual provider Active NPI Diagnostic Radiology Physician · Worcester, MA
NPI 1821031097 · NPPES record last updated Jun 8, 2021
Key facts
- NPI
- 1821031097
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- License
- 59177 (MA)
- Practice address
- 55 Lake Ave N
Worcester, MA 01655-0002 - Phone
- (508) 334-7237
- Fax
- (774) 441-8443
- NPI assigned
- Jun 14, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 10
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050412001138 | MA | Practitioner - Diagnostic Radiology | 9335186220 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 59177 | MA | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Umass Memorial MRI & Imaging Center LLC | Current |
Accepting new patients | |
| Boston Podiatry Services PC | Current | Accepting new patients | |
| Umass Memorial MRI & Imaging Center LLC | Current |
Accepting new patients | |
| Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc | Current | Accepting new patients | |
| Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc | Current |
Accepting new patients | |
| Harvard Medical Faculty Physicians at Beth Israel Deaconess Medical Ce | Diagnostic Radiology | Current |
Accepting new patients |
| Umass Memorial Radiology Phys Serv | Diagnostic Radiology | Current |
Accepting new patients |
| Umass Memorial Medical Group Inc | Current |
Accepting new patients | |
| Umass Memorial MRI & Imaging Center, LLC | Diagnostic Radiology | Current |
Accepting new patients |
| Umass Memorial Medical Group, Inc. | Current |
Accepting new patients |
Locations
330 Brookline Ave
#4
Boston, MA 02215
Phone (617) 667-1282
330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000
10 N Main St
Charlton, MA 01507
Phone (508) 248-3015
157 Union St
Marlborough, MA 01752
Phone (508) 481-5000
340 Thompson Rd
Webster, MA 01570
Phone (508) 943-2600
10 Little Brook Rd
West Wareham, MA 02576
55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862
Interoperability endpoints
- mrosen8291@umassmemorial.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 59177 | MA | Yes |
Addresses
Primary practice location
55 Lake Ave N
Worcester, MA 01655-0002
Mailing address
PO Box 415348
Boston, MA 02241-5348
Phone (800) 225-8885
Other practice location 1
157 Union St
Marlborough, MA 01752-1228
Phone (508) 486-5600
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110049624A | Medicaid | MA |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mrosen8291@UmassMemorial.direct-ci.com | ||
| FHIR URL | https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ |
Other providers in Worcester, MA
- Sandra Rose
- Erica Latoya Roseboro
- Tajee Rosemin
- Emily Rosen
- Larry P Rosen
- Paul M. Rosen
- Yael L Rosen
- Christopher D. Rosenbaum
- Elana L. Rosenbaum
- Thomas Lee Rosenfeld
All providers in Worcester, MA · Diagnostic Radiology Physician in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 8, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.