Individual provider Active NPI

Mayer Rosenberg, PA

  • Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1942347950
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
011712 Issued in NY
Practice address
735 Bedford Ave
Brooklyn, NY 11205-1507
Phone
(929) 382-4736
NPI assigned
Jan 31, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 011712 NY Primary

Addresses

Primary practice location

735 Bedford Ave
Brooklyn, NY 11205-1507

Mailing address

694 Myrtle Ave # 180
Brooklyn, NY 11205-3916
Phone (929) 382-4736

Other practice location 1

80 Seymour Street
Hartford Hospital Emergency Medicine
Hartford, CT 06102-5037
Phone (860) 972-0000

Other identifiers 1

IdentifierTypeStateIssuer
03251094MedicaidNY

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
I20080212000246 NY Practitioner - Physician Assistant 6608959820 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Parcare Community Health Network IncGroup PAC ID 4981823390, 99 clinicians

Practice addresses (Care Compare)

445 Park Ave
Brooklyn, NY 11205-2735
Phone (718) 963-0800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
011712NYMDMental Health Counselor
3172CTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Care PLLC Current Accepting new patients
Parcare Community Health Network Inc CurrentSince Mar 1, 2020 Accepting new patients
Rockland Medical Group, PLLC PastSince Apr 15, 2017 Accepting new patients
Pharma Holding Inc PastSince Jul 23, 2023 Accepting new patients
Lich Faculty Practice Physician Assistant Past Accepting new patients
BMN Medical P.C. PastSince Jan 20, 2022 Accepting new patients

Locations

445 Park Ave
Brooklyn, NY 11205
Phone (718) 965-1320

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Organizations & group practices 8

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": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1942347950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "694 MYRTLE AVE # 180",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112053916",
            "telephone_number": "929-382-4736",
            "fax_number": "877-991-9061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 BEDFORD AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112051507",
            "telephone_number": "929-382-4736"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "80 Seymour Street",
            "address_2": "Hartford Hospital Emergency Medicine",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061025037",
            "country_code": "US",
            "telephone_number": "860-972-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSENBERG",
        "first_name": "MAYER",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "011712",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03251094",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.