Individual provider Active NPI

Diane Grace Rossello, D.C.

  • Chiropractor
  • Bowie, MD
National Provider Identifier
1861565343
Registry record updated May 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
SO1133 Issued in MD
Practice address
4000 Mitchellville Rd
Suite B122
Bowie, MD 20716-3104
Phone
(301) 464-9400
NPI assigned
Nov 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X SO1133 MD Primary

Addresses

Primary practice location

4000 Mitchellville Rd
Suite B122
Bowie, MD 20716-3104

Mailing address

PO Box 1687
Edgewater, MD 21037-7687
Phone (301) 464-9400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050330000384 DC Practitioner - Chiropractic 8820044126 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1980
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4000 Mitchellville Rd
Suite B122
Bowie, MD 20716-3120
Phone (301) 464-9400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SO1133MDMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Rossello Family Chiropractic, PA Chiropractor CurrentSince Jan 1, 2005 Accepting new patients

Locations

4000 Mitchellville Rd
Ste B122
Mitchellville, MD 20716
Phone (301) 464-9400

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556668800000",
    "number": "1861565343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1687",
            "city": "EDGEWATER",
            "state": "MD",
            "postal_code": "210377687",
            "telephone_number": "301-464-9400",
            "fax_number": "301-464-2972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 MITCHELLVILLE RD",
            "address_2": "SUITE B122",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207163104",
            "telephone_number": "301-464-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSSELLO",
        "first_name": "DIANE",
        "middle_name": "GRACE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2019-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "SO1133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.