Individual provider Active NPI

Peter A Rosario, M.D.

  • Pulmonary Disease Physician
  • Evansville, IN
National Provider Identifier
1821045139
Registry record updated Oct 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
01038767 Issued in IN
Practice address
901 Saint Marys Dr
Suite 200
Evansville, IN 47714-0520
Phone
(812) 485-6030
Fax
(812) 485-6032
NPI assigned
May 30, 2006
Last updated
Oct 31, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 01038767 IN Primary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 01038767A IN

Addresses

Primary practice location

901 Saint Marys Dr
Suite 200
Evansville, IN 47714-0520

Mailing address

901 Saint Marys Dr
Suite 200
Evansville, IN 47714-0520
Phone (812) 485-6030

Other identifiers 4

IdentifierTypeStateIssuer
64871742MedicaidKY
P00377503OtherINRAILROAD MEDICARE
000000488749OtherINANTHEM
100322910MedicaidIN

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 Medicine

State licenses

LicenseStateTypeSpecialty
01038767AINMDCritical Care Medicine (Internal Medicine) Physician
01038767INMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Mary's Physician Network LLC. Pulmonary Disease 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320019200000",
    "number": "1821045139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 SAINT MARYS DR",
            "address_2": "SUITE 200",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140520",
            "telephone_number": "812-485-6030",
            "fax_number": "812-485-6032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 SAINT MARYS DR",
            "address_2": "SUITE 200",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140520",
            "telephone_number": "812-485-6030",
            "fax_number": "812-485-6032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSARIO",
        "first_name": "PETER",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2011-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IN",
            "license": "01038767",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IN",
            "license": "01038767A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64871742",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00377503",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000488749",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100322910",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.