NPIMap

Individual provider Active NPI

Jason Emmanuel Rosenberg, D.O.

  • Physical Medicine & Rehabilitation Physician
  • Colorado Springs, CO
National Provider Identifier
1871791038
Registry record updated Feb 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
DR.0067216 Issued in CO
Practice address
4110 Briargate Pkwy Ste 100B
Colorado Springs, CO 80920-7836
Phone
(719) 364-0160
Fax
(719) 364-0161
NPI assigned
Jul 10, 2007
Last updated
Feb 15, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X A-1557-10 NM
Physical Medicine & Rehabilitation Physician 208100000X DR.0067216 CO Primary

Addresses

Primary practice location

4110 Briargate Pkwy Ste 100B
Colorado Springs, CO 80920-7836

Mailing address

2695 Rocky Mountain Ave Ste 150
Loveland, CO 80538-9071
Phone (970) 624-4451

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20220308000677 CO Practitioner - Physical Medicine and Rehabilitation 7719170463 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Lake Erie College of Osteopathic Medicine, Erie, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians
Select Physical Therapy of Colorado Springs LPGroup PAC ID 3971498197, shared by 2 NPIs, 84 clinicians

Practice addresses (Care Compare)

4110 Briargate Pkwy
Colorado Springs, CO 80920-7835
Phone (719) 364-0160

5825 Delmonico Dr
Colorado Springs, CO 80919-2243
Phone (719) 257-4240

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0067216COMDPhysical Medicine & Rehabilitation Physician
A-1557-10NMMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC Physical Medicine & Rehabilitation Current Accepting new patients
Poudre Valley Medical Group, LLC Physical Medicine & Rehabilitation CurrentSince Feb 28, 2022 Accepting new patients
Familycare Associates,PA Past Accepting new patients

Locations

4110 Briargate Pkwy
Ste 100
Colorado Springs, CO 80920
Phone (719) 364-0160

4110 Briargate Pkwy
Ste 100B
Colorado Springs, CO 80920
Phone (719) 364-0160

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

Organizations & group practices 3

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 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644883200000",
    "number": "1871791038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2695 ROCKY MOUNTAIN AVE STE 150",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805389071",
            "telephone_number": "970-624-4451",
            "fax_number": "970-490-4199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 BRIARGATE PKWY STE 100B",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809207836",
            "telephone_number": "719-364-0160",
            "fax_number": "719-364-0161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBERG",
        "first_name": "JASON",
        "middle_name": "EMMANUEL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-10",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NM",
            "license": "A-1557-10",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CO",
            "license": "DR.0067216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.