Individual provider Active NPI

Logan Kyle Rosenberg, MD

  • Pulmonary Disease Physician
  • Meriden, CT
National Provider Identifier
1972131845
Registry record updated Sep 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
85844 Issued in CT
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

Updated by the provider on Sep 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200623000638 OR Order and Referring Only - Internal MedicinePractitioner - 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

Verify at the official NPI Registry.