Organization Active NPI

Rose Neurology, PC

  • Sleep Medicine (Psychiatry & Neurology) Physician
  • Dearborn, MI
National Provider Identifier
1831722560
Registry record updated Feb 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084S0012X
Legal business name
ROSE NEUROLOGY, PC
Practice address
5141 Oakman Blvd
Dearborn, MI 48126-3763
Phone
(313) 846-3057
Fax
(844) 209-1584
NPI assigned
Feb 21, 2020
Last updated
Feb 21, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2020

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

Authorized official

Name
Christina Rose, MDNPI 1275740847
Title
Owner
Phone
(248) 846-3057

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Psychiatry & Neurology) Physician 2084S0012X NU Primary

Addresses

Primary practice location

5141 Oakman Blvd
Dearborn, MI 48126-3763

Mailing address

5141 Oakman Blvd
Dearborn, MI 48126-3763
Phone (313) 846-3057

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200603002075 MI Part B Supplier - Clinic/Group Practice 4587085394 Receives reassigned benefits from 1 practitioner
Practice locations: Dearborn, MI

National Provider Directory

National Provider Directory

Locations

5141 Oakman Blvd
Dearborn, MI 48126
Phone (313) 359-8200

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1582243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582243200000",
    "number": "1831722560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5141 OAKMAN BLVD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481263763",
            "telephone_number": "313-846-3057",
            "fax_number": "844-209-1584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5141 OAKMAN BLVD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481263763",
            "telephone_number": "313-846-3057",
            "fax_number": "844-209-1584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSE NEUROLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-21",
        "last_updated": "2020-02-21",
        "certification_date": "2020-02-21",
        "status": "A",
        "authorized_official_last_name": "ROSE",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-846-3057",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.