Peter A Rosa, MD, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

050684 Issued in NY

Practice address

3304 Bell Blvd
Bayside, NY 11361-1603

Phone

(718) 428-8900

NPI assigned

Dec 8, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jun 11, 2022 through Jun 11, 2028

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: prosa51498@northwell.direct-ci.com

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.

• Oral & Maxillofacial Surgery Associates, PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Bayside, NY
  • NPI 1598787624
  NPD (past)
• Bergen Oral Surgery Group PA

  • Oral and Maxillofacial Surgery (Dentist)
  • Hackensack, NJ
  • NPI 1316024458
  NPD (past)
• Summit Oral and Maxillofacial Surgery,PA

  • Oral and Maxillofacial Surgery (Dentist)
  • Summit, NJ
  • NPI 1437275716
  NPD (past)

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

{
    "created_epoch": "1197072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318550400000",
    "number": "1861675233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3304 BELL BLVD",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113611603",
            "telephone_number": "718-428-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3304 BELL BLVD",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113611603",
            "telephone_number": "718-428-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSA",
        "first_name": "PETER",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD, DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-08",
        "last_updated": "2011-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "050684",
            "primary": true
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "NY",
            "license": "252694",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ala Roh
• Lillian Rojas-McCollin, BA PSYCHOLOGY
• Marc Thomas Romanello, LCSW
• Jamel Romeo, D.C.
• Guerline Celeste Romulus
• Sophia Rosa
• Crystal Alicia Rosado
• Carmen Rosario, MSW
• George Luis Rosario Jr.
• Jennifer Rosario

• Oral and Maxillofacial Surgery (Dentist) in Bayside, NY
• Providers in Bayside, NY by specialty
• Oral and Maxillofacial Surgery (Dentist) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.