Mark Elliot Rosen, DO

Primary specialty

Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X

License

20 A 4880 Issued in CA

Practice address

4370 Alpine Rd Ste 205
Portola Valley, CA 94028-7953

Phone

(650) 529-0304

Fax

(650) 529-1479

NPI assigned

Mar 1, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Mar 2, 2016 through Mar 2, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391212800000",
    "number": "1942338009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4370 ALPINE RD STE 205",
            "city": "PORTOLA VALLEY",
            "state": "CA",
            "postal_code": "940287953",
            "telephone_number": "650-529-0304",
            "fax_number": "650-529-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4370 ALPINE RD STE 205",
            "city": "PORTOLA VALLEY",
            "state": "CA",
            "postal_code": "940287953",
            "telephone_number": "650-529-0304",
            "fax_number": "650-529-1479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEN",
        "first_name": "MARK",
        "middle_name": "ELLIOT",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2014-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "CA",
            "license": "20 A 4880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rochelle Marie Perucca, M.F.T.
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• Richard H. Laude, M.D., Inc.
• Massy Safai, M.D.
• Gerard D. Sarnat, M.D.
• Lawrence Alan Saunders, DMD,MS
• George Michael Savage, M.D.
• Diane J Schiano, PHD, MACP (2012)

• Neuromusculoskeletal Medicine & OMM Physician in Portola Valley, CA
• Providers in Portola Valley, CA by specialty
• Neuromusculoskeletal Medicine & OMM Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2014; 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.

Verify at the official NPI Registry.