Individual provider Active NPI

Daniel Roseman, M.D.

  • Internal Medicine Physician
  • Boston, MA
National Provider Identifier
1952530032
Registry record updated Feb 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
242076 Issued in MA
Practice address
80 East Concord Street
E-124
Boston, MA 02118-2307
Phone
(617) 414-5000
NPI assigned
Jul 9, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 242076 MA Primary

Addresses

Primary practice location

80 East Concord Street
E-124
Boston, MA 02118-2307

Mailing address

80 East Concord Street
E-124
Boston, MA 02118-2307

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20180831000005 IL Practitioner - NephrologyPractitioner - Internal Medicine 5799002101 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Rush Medical College of Rush University, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5140 N California Ave
Suite 510
Chicago, IL 60625-3600
Phone (312) 767-7811

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
242076MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois Kidney Care PLLC CurrentSince Jun 1, 2019 Accepting new patients

Locations

2620 W Addison St
Chicago, IL 60618
Phone (773) 248-0462

5140 N California Ave
Ste 510
Chicago, IL 60625
Phone (773) 293-2100

5145 N California Ave
Chicago, IL 60625
Phone (773) 989-3800

2740 W Foster Ave
Ste 417
Chicago, IL 60625
Phone (773) 275-7900

3023 N Clark St
#302
Chicago, IL 60657

Organizations & group practices 1

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1247097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423267200000",
    "number": "1952530032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 EAST CONCORD STREET",
            "address_2": "E-124",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 EAST CONCORD STREET",
            "address_2": "E-124",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182307",
            "telephone_number": "617-414-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEMAN",
        "first_name": "DANIEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-09",
        "last_updated": "2015-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "242076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.