Active NPI
Logan Kyle Rosenberg, MD
- Pulmonary Disease Physician
- Meriden, CT
National Provider Identifier
1972131845
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- 85844
- Practice address
- 455 Lewis Ave Ste 206
Meriden, CT 06451-2121 - Phone
- (203) 238-9446
- NPI assigned
- Mar 27, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Disease Physician | 207RP1001X | 85844 | CT | Primary |
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | 85844 | CT |
Addresses
Primary practice location
455 Lewis Ave Ste 206
Meriden, CT 06451-2121
Mailing address
1290 Silas Deane Hwy
Wethersfield, CT 06109-4337
Phone (860) 972-9093
Other practice location 1
1200 E Marshall St
Richmond, VA 23298-5023
Phone (800) 762-6161
Other practice location 2
1200 NW 23rd Ave
Portland, OR 97210-2906
Phone (503) 413-7074
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200623000638 | OR | Order and Referring Only - Internal Medicine | 0042632911 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788912000000",
"number": "1972131845",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1290 SILAS DEANE HWY",
"city": "WETHERSFIELD",
"state": "CT",
"postal_code": "061094337",
"telephone_number": "860-972-9093"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "455 LEWIS AVE STE 206",
"city": "MERIDEN",
"state": "CT",
"postal_code": "064512121",
"telephone_number": "203-238-9446"
}
],
"practiceLocations": [
{
"address_1": "1200 E Marshall St",
"address_purpose": "LOCATION",
"city": "Richmond",
"state": "VA",
"postal_code": "232985023",
"country_code": "US",
"telephone_number": "800-762-6161",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1200 NW 23rd Ave",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972102906",
"country_code": "US",
"telephone_number": "503-413-7074",
"fax_number": "503-413-6892",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROSENBERG",
"first_name": "LOGAN",
"middle_name": "KYLE",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-03-27",
"last_updated": "2026-09-09",
"certification_date": "2026-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "207RP1001X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "CT",
"license": "85844",
"primary": true
},
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "CT",
"license": "85844",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Meriden, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.