Philip T Roskos, PHD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

6301015810 Issued in MI

Practice address

18181 Oakwood Blvd Ste 411
Dearborn, MI 48124-4082

Phone

(313) 982-5150

Fax

(313) 982-5157

NPI assigned

Mar 25, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Electronic endpoints 6

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Saint Louis University School of Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Beaumont Medical Group- Specialty ServicesGroup PAC ID 7214299866, 868 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: proskos1253532@epic00.shdirect.org

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.

• Beaumont Medical Group- Specialty Services

  • Surgery Physician
  • Royal Oak, MI
  • NPI 1578072906
  Medicare reassignment Care Compare group NPD
• Oakwood Ambulatory LLC

  • Internal Medicine Physician
  • Dearborn, MI
  • NPI 1003829441
  Medicare reassignment NPD
• University Physician Group

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1447299797
  Medicare reassignment
• Oakwood Ambulatory, LLC

  • Podiatrist
  • Westland, MI
  • NPI 1013157361
  NPD
• Oakwood Healthcare Inc

  • Community/Retail Pharmacy
  • Westland, MI
  • NPI 1033128178
  NPD (past)
• SSM Select Rehab St Louis LLC

  • Physical Medicine & Rehabilitation Physician
  • Richmond Heights, MO
  • NPI 1558403261

  Psychologist

  NPD (past)
• SSM Select Rehab St. Louis, LLC

  • Rehabilitation Practitioner
  • Breese, IL
  • NPI 1740166347
  NPD (past)

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

• William Beaumont Hospital

  • General Acute Care Hospital
  • Troy, MI
  • NPI 1306825997
  Care Compare affiliation
• William Beaumont Hospital

  • General Acute Care Hospital
  • Royal Oak, MI
  • NPI 1689653305
  Care Compare affiliation
• William Beaumont Hospital

  • General Acute Care Hospital
  • Grosse Pointe, MI
  • NPI 1932396017
  Care Compare affiliation

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

{
    "created_epoch": "1269475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664496000000",
    "number": "1821312430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18181 OAKWOOD BLVD STE 411",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481244082",
            "telephone_number": "313-982-5150",
            "fax_number": "313-982-5157"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "33155 Annapolis St",
            "address_purpose": "LOCATION",
            "city": "Wayne",
            "state": "MI",
            "postal_code": "481842405",
            "country_code": "US",
            "telephone_number": "734-467-4134",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17000 Hubbard Dr Ste 800",
            "address_purpose": "LOCATION",
            "city": "Dearborn",
            "state": "MI",
            "postal_code": "481264205",
            "country_code": "US",
            "telephone_number": "313-240-7595",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2707 W Jefferson Ave",
            "address_purpose": "LOCATION",
            "city": "Trenton",
            "state": "MI",
            "postal_code": "481832804",
            "country_code": "US",
            "telephone_number": "734-692-5903",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2050 N Haggerty Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "MI",
            "postal_code": "481873796",
            "country_code": "US",
            "telephone_number": "313-438-7397",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3601 W 13 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Royal Oak",
            "state": "MI",
            "postal_code": "480736712",
            "country_code": "US",
            "telephone_number": "248-898-7456",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSKOS",
        "first_name": "PHILIP",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-25",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MO",
            "license": "2008035687",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MO",
            "license": "2008035687",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301015810",
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "MO",
            "license": "2008035687",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MI",
            "license": "6301015810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "proskos111671@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "18181 Oakwood Blvd Ste 411",
            "city": "Dearborn",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481244082",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "proskos111671@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "33155 Annapolis St",
            "city": "Wayne",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481842405",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "proskos111671@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "17000 Hubbard Dr Ste 800",
            "city": "Dearborn",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481264205",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "proskos111671@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "2707 W Jefferson Ave",
            "city": "Trenton",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481832804",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "proskos111671@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "2050 N Haggerty Rd Ste 200",
            "city": "Canton",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481873796",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "proskos111671@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "3601 W 13 Mile Rd",
            "city": "Royal Oak",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480736712",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ammy Rosales
• Rose Neurology, PC
• Rebecca Rose, PA
• Victoria Elaine Rose
• Barry Philip Rosen, MD
• Allison Mae Ross, AGACNP-BC
• Christine C Ross, CRNA
• Gary Edward Ross, DO
• Jennifer L Ross, AGACNP-BC
• Jessica Ross

• Clinical Neuropsychologist in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Clinical Neuropsychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.