Individual provider Active NPI

David I Rosen, M.D.

  • Geriatric Medicine (Family Medicine) Physician
  • Lebanon, NJ
National Provider Identifier
1932206703
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
25MA03075300 Issued in NJ
Practice address
16 Cratetown Rd
Lebanon, NJ 08833-3008
Phone
(908) 236-2011
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X 25MA03075300 NJ Primary

Addresses

Primary practice location

16 Cratetown Rd
Lebanon, NJ 08833-3008

Mailing address

16A Cratetown Rd
Lebanon, NJ 08833-3008
Phone (908) 236-0387

Other identifiers 1

IdentifierTypeStateIssuer
0361500MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050523000360 NJ Practitioner - Family PracticePractitioner - Urology 6103738141 Practice locations: High Bridge, NJ

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA03075300NJMDGeriatric Medicine (Family Medicine) Physician

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932206703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16A CRATETOWN RD",
            "city": "LEBANON",
            "state": "NJ",
            "postal_code": "088333008",
            "telephone_number": "908-236-0387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 CRATETOWN RD",
            "city": "LEBANON",
            "state": "NJ",
            "postal_code": "088333008",
            "telephone_number": "908-236-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEN",
        "first_name": "DAVID",
        "middle_name": "I",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NJ",
            "license": "25MA03075300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0361500",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NJ

Sources for this page

Verify at the official NPI Registry.