NPIMap

Individual provider Active NPI

Douglas Michael Rosen, M.D.

  • Surgery Physician
  • Matthews, NC
National Provider Identifier
1851382139
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
200300403 Issued in NC
Practice address
1450 Matthews Township Pkwy Ste 230
Matthews, NC 28105-2388
Phone
(704) 384-8615
Fax
(704) 384-6792
NPI assigned
Nov 4, 2005
Last updated
Sep 18, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery Physician 208C00000X 200300403 NC
Surgery Physician 208600000X 200300403 NC Primary

Addresses

Primary practice location

1450 Matthews Township Pkwy Ste 230
Matthews, NC 28105-2388

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 333-1259

Other practice location 1

2015 Randolph Rd
Suite 201
Charlotte, NC 28207-1200
Phone (704) 333-1259

Other identifiers 1

IdentifierTypeStateIssuer
891335CMedicaidNC

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address drosen34499@direct.novanthealth.org
Direct Messaging Address drosen34499@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101021001190 NC Practitioner - Colorectal Surgery (Proctology)Practitioner - General Surgery 2769675792 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)Also: General Surgery
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

1718 E 4TH St
Suite 307
Charlotte, NC 28204-3283
Phone (704) 333-1259

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy48

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Medical Group, Inc CurrentSince Feb 13, 2013 Accepting new patients
The Presbyterian Hospital Current Accepting new patients
The Presbyterian Hospital Surgery CurrentSince Oct 4, 2020 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Feb 13, 2013 Accepting new patients
The Presbyterian Hospital CurrentSince Oct 4, 2020 Accepting new patients
Novant Health Medical Group, LLC Surgery Past Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

125 Queens Rd
Charlotte, NC 28204
Phone (980) 302-6000

125 Queens Rd
Ste 430
Charlotte, NC 28204
Phone (980) 302-6300

1718 E 4th St
Ste 307
Charlotte, NC 28204
Phone (704) 333-1259

330 Billingsley Rd
Ste 202
Charlotte, NC 28211
Phone (704) 316-2350

335 N Caswell Rd
Charlotte, NC 28204
Phone (704) 384-7390

6324 Fairview Rd
Ste 330
Charlotte, NC 28210
Phone (704) 316-1950

9930 Kincey Ave
Ste 210
Huntersville, NC 28078
Phone (704) 316-3492

1450 Matthews Township Pkwy
Ste 230
Matthews, NC 28105
Phone (704) 384-8615

134 Medical Park Rd
Ste 200
Mooresville, NC 28117
Phone (704) 384-7972

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: drosen34499@direct.novanthealth.org

Organizations & group practices 8

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1851382139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-333-1259",
            "fax_number": "704-333-0371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 MATTHEWS TOWNSHIP PKWY STE 230",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281052388",
            "telephone_number": "704-384-8615",
            "fax_number": "704-384-6792"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2015 Randolph Rd",
            "address_2": "Suite 201",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282071200",
            "country_code": "US",
            "telephone_number": "704-333-1259",
            "fax_number": "704-333-0371",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSEN",
        "first_name": "DOUGLAS",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "NC",
            "license": "200300403",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "200300403",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891335C",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drosen34499@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "2015 Randolph Rd",
            "address_2": "Suite 201",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282071200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drosen34499@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "1450 Matthews Township Pkwy Ste 230",
            "city": "Matthews",
            "state": "NC",
            "country_code": "US",
            "postal_code": "281052388",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Matthews, NC

Sources for this page

Verify at the official NPI Registry.