Individual provider Active NPI

Dylan Michael Rose

  • Physician Assistant
  • Cincinnati, OH
National Provider Identifier
1922553452
Registry record updated Sep 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.007131RX Issued in OH
Practice address
500 E Business Way
Cincinnati, OH 45241-2374
Phone
(513) 354-3700
Fax
(513) 354-3705
NPI assigned
Aug 25, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 50.007131RX OH Primary

Addresses

Primary practice location

500 E Business Way
Cincinnati, OH 45241-2374

Mailing address

6480 Harrison Ave Ste 201
Cincinnati, OH 45247-7961
Phone (513) 354-7650

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20210913001820 OH Practitioner - Physician Assistant 9436555737 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beacon Orthopaedics and Sports Medicine LTDGroup PAC ID 0345136412, 471 clinicians
Oxford Physical Therapy and RehabilitationGroup PAC ID 0244232874, 432 clinicians

Practice addresses (Care Compare)

500 E Business Way
Cincinnati, OH 45241-2374
Phone (513) 251-7827

6480 Harrison Ave
Cincinnati, OH 45247-7821
Phone (513) 354-3700

7567 Central Parke Blvd
A
Mason, OH 45040-6852

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50.007131RXOHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Orthopaedics & Sports Medicine LTD CurrentSince Aug 30, 2021 Accepting new patients
Beacon Orthopaedics & Sports Medicine, LTD Physician Assistant CurrentSince Aug 30, 2021 Accepting new patients

Locations

500 E Business Way
Ste A
Cincinnati, OH 45241
Phone (513) 389-3666

6480 Harrison Ave
Ste 201
Cincinnati, OH 45247
Phone (513) 354-7650

6480 Harrison Ave
Cincinnati, OH 45247
Phone (513) 251-7827

500 E Business Way
Sharonville, OH 45241
Phone (513) 251-7827

Interoperability endpoints

  • Direct secure messaging: dylan.rose.p1@direct.beaconortho.nextgenshare.com

Organizations & group practices 3

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": "1472083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1922553452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6480 HARRISON AVE STE 201",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452477961",
            "telephone_number": "513-354-7650",
            "fax_number": "513-354-7651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 E BUSINESS WAY",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452412374",
            "telephone_number": "513-354-3700",
            "fax_number": "513-354-3705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "DYLAN",
        "middle_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-25",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.007131RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.