Individual provider Active NPI

Carl A Rosenbaum, MD

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1881605103
Registry record updated May 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD026087E Issued in PA
Practice address
10160 Bustleton Ave
Suite a
Philadelphia, PA 19116
Phone
(215) 464-0770
Fax
(267) 579-0720
NPI assigned
Aug 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2013

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 MD026087E PA Primary

Addresses

Primary practice location

10160 Bustleton Ave
Suite a
Philadelphia, PA 19116

Mailing address

10160 Bustleton Ave
Suite a
Philadelphia, PA 19116
Phone (215) 464-0770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20070302000139 PA Practitioner - Internal Medicine 5890771109 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD026087EPAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
HR Physician Services Internal Medicine CurrentSince Jan 1, 2013 Accepting new patients
HR Physician Services Internal Medicine Current Accepting new patients
HR Physician Services Internal Medicine CurrentSince Jan 1, 2013 Accepting new patients
Visiting Nurse and Health Services PastSince Jan 1, 2013 Accepting new patients

Locations

23 Bustleton Pike
Feasterville Trevose, PA 19053
Phone (215) 322-5938

23 Bustleton Pike
Ste 200A
Feasterville Trevose, PA 19053
Phone (215) 464-0770

23 Bustleton Pike
Ste 200
Feasterville Trevose, PA 19053
Phone (215) 464-0770

1648 Huntingdon Pike
Fl 2
Meadowbrook, PA 19046

1648 Huntingdon Pike
Meadowbrook, PA 19046
Phone (215) 938-3413

10160 Bustleton Ave
Ste A
Philadelphia, PA 19116
Phone (215) 364-0777

Interoperability endpoints

  • Direct secure messaging: carl.rosenbaum.1@17399.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Holy Redeemer Home Care- NJ SouthRunnemede, NJ, CCN 317025 Home health agency Corporate Director
W-2 Managing Employee
Oct 1, 2004
Oct 1, 2004

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368662400000",
    "number": "1881605103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10160 BUSTLETON AVE",
            "address_2": "SUITE A",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19116",
            "telephone_number": "215-464-0770",
            "fax_number": "267-579-0720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10160 BUSTLETON AVE",
            "address_2": "SUITE A",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19116",
            "telephone_number": "215-464-0770",
            "fax_number": "267-579-0720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBAUM",
        "first_name": "CARL",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2013-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD026087E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.