Individual provider Active NPI

Bruce T. Rose, MD

  • Internal Medicine Physician
  • Princeton, NJ
National Provider Identifier
1861420077
Registry record updated Apr 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA08162800 Issued in NJ
Practice address
811 Executive Dr
Princeton, NJ 08540-1530
Phone
(606) 303-4600
Fax
(609) 303-4601
NPI assigned
Jun 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA08162800 NJ Primary

Addresses

Primary practice location

811 Executive Dr
Princeton, NJ 08540-1530

Mailing address

811 Executive Dr
Princeton, NJ 08540-1530
Phone (609) 303-4600

Other practice location 1

419 N Harrison St
Princeton, NJ 08540-3521
Phone (609) 924-9300

Other practice location 2

811 Executive Dr
Princeton, NJ 08540-1530
Phone (606) 303-4600

Other identifiers 1

IdentifierTypeStateIssuer
5841909MedicaidVA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bruce.rose.1@12833.direct.athenahealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070223000494 NJ Practitioner - Internal Medicine 2567564487 Reassigns benefits to 1 organization
I20161108001122 PA Practitioner - Internal Medicine 2567564487 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Temple University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Capital Health Medical GroupGroup PAC ID 7618264532, 442 clinicians

Practice addresses (Care Compare)

1 Capital Way
Pennington, NJ 08534-2520
Phone (609) 303-4244

1050 Stony Hill Rd
Yardley, PA 19067-5500
Phone (215) 504-1761

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.91 of 100Reported as apm
Quality
79.42
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA08162800NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Health Medical Group Internal Medicine CurrentSince Sep 13, 2016 Accepting new patients
Capital Pediatric Hospitalists Past Accepting new patients
Capital Emergency Physicians & Associates Past Accepting new patients
Princeton Medical Group, P.a. Past Accepting new patients

Locations

1700 Nottingham Way
Ste 108
Hamilton, NJ 08619
Phone (609) 303-4870

3131 Princeton Pike
Bldg 5
Lawrenceville, NJ 08648
Phone (609) 844-9661

3131 Princeton Pike
Ste 208
Lawrenceville, NJ 08648
Phone (609) 394-6029

1 Capital Way
Pennington, NJ 08534
Phone (609) 303-4000

811 Executive Dr
Princeton, NJ 08540
Phone (606) 303-4600

750 Brunswick Ave
Trenton, NJ 08638
Phone (609) 394-6000

1050 Stony Hill Rd
Yardley, PA 19067
Phone (215) 504-1761

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12833/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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.

Hospital & facility affiliations 4

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": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619395200000",
    "number": "1861420077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 EXECUTIVE DR",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085401530",
            "telephone_number": "609-303-4600",
            "fax_number": "609-303-4601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 EXECUTIVE DR",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085401530",
            "telephone_number": "606-303-4600",
            "fax_number": "609-303-4601"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "419 N Harrison St",
            "address_purpose": "LOCATION",
            "city": "Princeton",
            "state": "NJ",
            "postal_code": "085403521",
            "country_code": "US",
            "telephone_number": "609-924-9300",
            "fax_number": "609-924-3477",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "811 Executive Dr",
            "address_purpose": "LOCATION",
            "city": "Princeton",
            "state": "NJ",
            "postal_code": "085401530",
            "country_code": "US",
            "telephone_number": "606-303-4600",
            "fax_number": "609-303-4601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSE",
        "first_name": "BRUCE",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA08162800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5841909",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bruce.rose.1@12833.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "811 Executive Dr",
            "city": "Princeton",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "085401530",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Princeton, NJ

Sources for this page

Verify at the official NPI Registry.