Individual provider Active NPI

Christopher M Rose, M.D.

  • Radiation Oncology Physician
  • Burbank, CA
National Provider Identifier
1952309569
Registry record updated Jun 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
C43111 Issued in CA
Practice address
181 S Buena Vista St
Burbank, CA 91505-4504
Phone
(818) 847-3440
Fax
(818) 847-3499
NPI assigned
Jul 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X G49966 CA
Radiation Oncology Physician 2085R0001X C43111 CA Primary

Addresses

Primary practice location

181 S Buena Vista St
Burbank, CA 91505-4504

Mailing address

PO Box 513969
Los Angeles, CA 90051-3969
Phone (310) 335-4065

Other identifiers 5

IdentifierTypeStateIssuer
00G499660MedicaidCA
920007065OtherCORR MEDICARE - CO
59186232MedicaidCO
300080912OtherCARR MEDICARE
920006960OtherCARR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20050204000799 CA Practitioner - Radiation Oncology 3678487022 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C43111CAMDRadiation Oncology Physician
49966CAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Clarita Radiotherapy Medical Group Radiation Oncology Past Accepting new patients
Western Tumor Medical Group Inc Specialist Past Accepting new patients
Valley Radiotherapy Associates Medical Group Inc Radiation Oncology Past Accepting new patients

Organizations & group practices 4

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": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433116800000",
    "number": "1952309569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 513969",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900513969",
            "telephone_number": "310-335-4065",
            "fax_number": "310-335-4098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 S BUENA VISTA ST",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054504",
            "telephone_number": "818-847-3440",
            "fax_number": "818-847-3499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "CHRISTOPHER",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2015-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G49966",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "CA",
            "license": "C43111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G499660",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE - CO",
            "identifier": "920007065",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "59186232",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "300080912",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "920006960",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

Verify at the official NPI Registry.