Individual provider Active NPI

Simon Walter Rosenberg, D.M.D.

  • Prosthodontics
  • New York, NY
National Provider Identifier
1982759049
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
33545 Issued in NY
Practice address
399 E 72ND St
Suite #1a
New York, NY 10021-4648
Phone
(212) 988-8822
Fax
(212) 988-8858
NPI assigned
Jan 25, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X 33545 NY Primary

Addresses

Primary practice location

399 E 72ND St
Suite #1a
New York, NY 10021-4648

Mailing address

399 E 72ND St
Suite #1a
New York, NY 10021-4648
Phone (212) 988-8822

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20151203001393 NY Practitioner - Oral SurgeryPractitioner - Sleep Medicine 7618280868 Practice locations: New York, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33545NYMDProsthodontist

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982759049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "399 E 72ND ST",
            "address_2": "SUITE #1A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214648",
            "telephone_number": "212-988-8822",
            "fax_number": "212-988-8858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "399 E 72ND ST",
            "address_2": "SUITE #1A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214648",
            "telephone_number": "212-988-8822",
            "fax_number": "212-988-8858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBERG",
        "first_name": "SIMON",
        "middle_name": "WALTER",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "NY",
            "license": "33545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.