Individual provider Active NPI

Jamie Scott Rosen, DDS

  • Dentist
  • Brooklyn, NY
National Provider Identifier
1902887391
Registry record updated May 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
035221 Issued in NY
Practice address
4401 Avenue D
Brooklyn, NY 11203-5725
Phone
(718) 451-1888
Fax
(718) 451-1920
NPI assigned
Nov 11, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 035221 NY Primary

Addresses

Primary practice location

4401 Avenue D
Brooklyn, NY 11203-5725

Mailing address

4401 Avenue D
Brooklyn, NY 11203-5725
Phone (718) 451-1888

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161122001505 NY Order and Referring Only - DentistPractitioner - Dentist 1951680594

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Avenue D Professional Group P.C. Past Accepting new patients
Avenue D Dental PLLC PastSince Jul 31, 2023 Accepting new patients

Organizations & group practices 2

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": "1131667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368144000000",
    "number": "1902887391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 AVENUE D",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112035725",
            "telephone_number": "718-451-1888",
            "fax_number": "718-451-1920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 AVENUE D",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112035725",
            "telephone_number": "718-451-1888",
            "fax_number": "718-451-1920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEN",
        "first_name": "JAMIE",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-11",
        "last_updated": "2013-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "035221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.