Active NPI
Regina Lori Rosenthal, MD
- Plastic Surgery Physician
- Campbell, CA
National Provider Identifier
1902905698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- License
- G49413
- Practice address
- 3803 South Bascom Ave
#206
Campbell, CA 95008 - Phone
- (408) 559-4700
- Fax
- (408) 377-6470
- NPI assigned
- Sep 21, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Physician | 208200000X | G49413 | CA | Primary |
Addresses
Primary practice location
3803 South Bascom Ave
#206
Campbell, CA 95008
Mailing address
3803 South Bascom Ave
#206
Campbell, CA 95008
Phone (408) 559-4700
Medicare participation
Medicare enrollment files- 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
- Opted out of Medicare
- Yes, effective May 31, 2016 through May 31, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 49413 | CA | MD | General Practice Dentistry |
| G49413 | CA | MD | Plastic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1345507200000",
"number": "1902905698",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3803 SOUTH BASCOM AVE",
"address_2": "#206",
"city": "CAMPBELL",
"state": "CA",
"postal_code": "95008",
"telephone_number": "408-559-4700",
"fax_number": "408-377-6470"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3803 SOUTH BASCOM AVE",
"address_2": "#206",
"city": "CAMPBELL",
"state": "CA",
"postal_code": "95008",
"telephone_number": "408-559-4700",
"fax_number": "408-377-6470"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSENTHAL",
"first_name": "REGINA",
"middle_name": "LORI",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-21",
"last_updated": "2012-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "CA",
"license": "G49413",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Campbell, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2012; 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.