Rose M Mack, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MB69803 Issued in NJ

Practice address

225 Williamson St
Elizabeth, NJ 07202-3625

Phone

(908) 994-5422

NPI assigned

Dec 4, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Emergency Physician Associates of North Jersey P C

  • Emergency Medicine Physician
  • Summit, NJ
  • NPI 1497783419
  Medicare reassignment NPD
• Somerset Valley Urgent Care, L.L.C.

  • Urgent Care Clinic/Center
  • Bedminster, NJ
  • NPI 1730330655
  Medicare reassignment NPD
• Tidal Emergency Physicians LLC

  • Emergency Medicine Physician
  • Neptune, NJ
  • NPI 1649222407
  NPD (past)

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1831267152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "THE SOMERSET NETWORK",
            "address_2": "P.O. BOX 70",
            "city": "WESTFIELD",
            "state": "NJ",
            "postal_code": "07091",
            "telephone_number": "908-317-6807",
            "fax_number": "908-317-6896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 WILLIAMSON ST",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072023625",
            "telephone_number": "908-994-5422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "ROSE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2012015751",
            "primary": false
        },
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "NJ",
            "license": "61-19569",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "MB69803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8565007",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathryn C Lynch, LSW
• Lysandra Plotkin, D.M.D LLC
• M & a Professional Service LLC
• Wenkai Ma, MD
• Abigail Macabingkil, PHARMD
• Matthew Mackowsky
• Magaly Campos-Munoz, M.D., P.a.
• Deanna C. Magnaye, RDN
• Margaret R. Mahon, APN
• Brenda Le Mai

• Emergency Medicine Physician in Elizabeth, NJ
• Providers in Elizabeth, NJ by specialty
• Emergency Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.