NPIMap

Organization Active NPI

Frederic Rose, OD

  • Optometrist
  • Haverhill, MA
National Provider Identifier
1962613737
Registry record updated Feb 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
MA2139 Issued in MA
Legal business name
FREDERIC ROSE, OD
Practice address
72 Merrimack St
Haverhill, MA 01830-6207
Phone
(978) 374-0386
Fax
(978) 372-3631
NPI assigned
May 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2009

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

Authorized official

Name
Dr. Frederic Rose, ODNPI 1205817137
Title
Dr.
Phone
(978) 374-0386

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X MA2139 MA Primary

Addresses

Primary practice location

72 Merrimack St
Haverhill, MA 01830-6207

Mailing address

72 Merrimack St
Haverhill, MA 01830-6207
Phone (978) 374-0386

Other identifiers 7

IdentifierTypeStateIssuer
2200374OtherMAUNITED HEALTHCARE
1205817137OtherMABLUE CROSS BLUE SHIELD
1962613737OtherMAMEDICARE
0396516MedicaidMA
151464OtherMAHARVARD PILGRIM HEALTHCAR
507326OtherMAAETNA
705074OtherMATUFTS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235088000000",
    "number": "1962613737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72 MERRIMACK ST",
            "city": "HAVERHILL",
            "state": "MA",
            "postal_code": "018306207",
            "telephone_number": "978-374-0386",
            "fax_number": "978-372-3631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 MERRIMACK ST",
            "city": "HAVERHILL",
            "state": "MA",
            "postal_code": "018306207",
            "telephone_number": "978-374-0386",
            "fax_number": "978-372-3631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREDERIC ROSE, OD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-24",
        "last_updated": "2009-02-20",
        "status": "A",
        "authorized_official_last_name": "ROSE",
        "authorized_official_first_name": "FREDERIC",
        "authorized_official_title_or_position": "DR.",
        "authorized_official_telephone_number": "978-374-0386",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MA",
            "license": "MA2139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2200374",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1205817137",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1962613737",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0396516",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HEALTHCAR",
            "identifier": "151464",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "507326",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "705074",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Haverhill, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.