Individual provider Active NPI

Marta Ann Rosenberg, PHD

  • Clinical Psychologist
  • Galveston, TX
National Provider Identifier
1902139751
Registry record updated Nov 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
31257 Issued in TX
Practice address
815 Market St
Galveston, TX 77550-2725
Phone
(409) 770-6600
Fax
(409) 770-6919
NPI assigned
Sep 11, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 31257 TX Primary

Addresses

Primary practice location

815 Market St
Galveston, TX 77550-2725

Mailing address

PO Box 8500
Lockbox 7642
Philadelphia, PA 19178-7642
Phone (813) 281-8115

Other identifiers 1

IdentifierTypeStateIssuer
206361221MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091026000598 TX Practitioner - Clinical Psychologist 4880731777 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31257TXMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Shriners Hospitals for Children Current Accepting new patients

Locations

815 Market St
Galveston, TX 77550
Phone (409) 770-6600

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": "1252627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353369600000",
    "number": "1902139751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8500",
            "address_2": "LOCKBOX 7642",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191787642",
            "telephone_number": "813-281-8115",
            "fax_number": "813-281-8656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 MARKET ST",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775502725",
            "telephone_number": "409-770-6600",
            "fax_number": "409-770-6919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBERG",
        "first_name": "MARTA",
        "middle_name": "ANN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-11",
        "last_updated": "2012-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "31257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206361221",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Galveston, TX

Sources for this page

Verify at the official NPI Registry.