Individual provider Active NPI

Adam Miles Rosenberg, PA-C

  • Physician Assistant
  • Hicksville, NY
National Provider Identifier
1922504810
Registry record updated Apr 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
021948-1 Issued in NY
Practice address
87 W Old Country Rd
Hicksville, NY 11801-4003
Phone
(516) 433-1100
NPI assigned
Apr 1, 2018
Last updated
Apr 1, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 021948-1 NY Primary

Addresses

Primary practice location

87 W Old Country Rd
Hicksville, NY 11801-4003

Mailing address

6 Overlook LN
Plainview, NY 11803-3208
Phone (516) 578-2009

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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191112000545 NY Practitioner - Physician Assistant 6305278433 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2 5TH Ave
Suite 7
New York, NY 10011-8855
Phone (646) 580-3538

25 5TH Ave
Apt 1F
New York, NY 10003-4308
Phone (646) 580-3538

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
021948NYMDSpeech-Language Pathologist
021948-1NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rothman Orthopaedics of New York, PLLC CurrentSince Nov 25, 2019 Accepting new patients
Long Island Spine & Orthopedics, PC PastSince Sep 5, 2013 Accepting new patients
Long Island Gastroenterology & Liver P.C. PastSince May 11, 2019 Accepting new patients

Locations

658 White Plains Rd
Tarrytown, NY 10591
Phone (888) 636-7840

833 Chestnut St
Ste 520
Philadelphia, PA 19107
Phone (267) 592-6191

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1522540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522540800000",
    "number": "1922504810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 OVERLOOK LN",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118033208",
            "telephone_number": "516-578-2009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 W OLD COUNTRY RD",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118014003",
            "telephone_number": "516-433-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBERG",
        "first_name": "ADAM",
        "middle_name": "MILES",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-01",
        "last_updated": "2018-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "021948-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hicksville, NY

Sources for this page

Verify at the official NPI Registry.