Active NPI
John Albert Rose, DDS
- Periodontics
- Westbury, NY
National Provider Identifier
1912198862
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 051900-1
- Practice address
- 959 Brush Hollow Rd
Westbury, NY 11590-1778 - Phone
- (516) 333-6744
- NPI assigned
- Aug 6, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 051900-1 | NY | Primary |
Addresses
Primary practice location
959 Brush Hollow Rd
Westbury, NY 11590-1778
Mailing address
959 Brush Hollow Rd
Westbury, NY 11590-1778
Phone (516) 333-6744
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160215001394 | NY | Order and Referring Only - Other (Physician) | 2769786581 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051900-1 | NY | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186358400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186358400000",
"number": "1912198862",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "959 BRUSH HOLLOW RD",
"city": "WESTBURY",
"state": "NY",
"postal_code": "115901778",
"telephone_number": "516-333-6744"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "959 BRUSH HOLLOW RD",
"city": "WESTBURY",
"state": "NY",
"postal_code": "115901778",
"telephone_number": "516-333-6744"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSE",
"first_name": "JOHN",
"middle_name": "ALBERT",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-08-06",
"last_updated": "2007-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "NY",
"license": "051900-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Westbury, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2007; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.