Individual provider Active NPI

Diane Kang Rosonke, MD

  • Emergency Medicine Physician
  • Fresno, CA
National Provider Identifier
1861666067
Registry record updated Oct 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A101535 Issued in CA
Practice address
155 N Fresno St
Fresno, CA 93701-2302
Phone
(559) 499-6440
NPI assigned
Apr 17, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A101535 CA Primary

Addresses

Primary practice location

155 N Fresno St
Fresno, CA 93701-2302

Mailing address

155 N Fresno St
Fresno, CA 93701-2302
Phone (559) 499-6440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 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
I20151229002450 OR Practitioner - Emergency Medicine 1658414156 Reassigns benefits to 2 organizations
I20200412000068 WA Practitioner - Emergency Medicine 1658414156 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Acute Care Specialists PCGroup PAC ID 7012807373, 46 clinicians

Practice addresses (Care Compare)

2801 N Gantenbein Ave
Portland, OR 97227-1623
Phone (503) 413-2200

Hospital & facility affiliations

  • Legacy Mount Hood Medical Center Hospital, Gresham, OR, CCN 380025

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Columbia Medical Center CurrentSince Apr 1, 2019 Accepting new patients
Northwest Acute Care Specialists PC Emergency Medicine CurrentSince Jan 1, 2017 Accepting new patients
Northwest Acute Care Specialists PC Emergency Medicine CurrentSince Jan 1, 2017 Accepting new patients
Mid-Columbia Medical Center CurrentSince Apr 1, 2019 Accepting new patients
Mid-Columbia Medical Center Past Accepting new patients

Locations

24800 SE Stark St
Gresham, OR 97030
Phone (503) 413-8407

1015 NW 22nd Ave
Portland, OR 97210
Phone (503) 413-7582

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

1805 E 19th St
The Dalles, OR 97058
Phone (541) 296-2201

1700 E 19th St
The Dalles, OR 97058
Phone (541) 296-7251

19300 SW 65th Ave
Tualatin, OR 97062
Phone (503) 692-1212

2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985

Organizations & group practices 5

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 1

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": "1208390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288310400000",
    "number": "1861666067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 N FRESNO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937012302",
            "telephone_number": "559-499-6440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 N FRESNO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937012302",
            "telephone_number": "559-499-6440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSONKE",
        "first_name": "DIANE",
        "middle_name": "KANG",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-17",
        "last_updated": "2010-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A101535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.