Organization Active NPI

Bennett Rosenthal M.S.,PH.D.,M.D.,P.a.

  • Neurology Physician
  • Ocoee, FL
National Provider Identifier
1992781041
Registry record updated May 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
BENNETT ROSENTHAL M.S.,PH.D.,M.D.,P.A.
Practice address
10000 W Colonial Dr
Suite 289
Ocoee, FL 34761-3498
Phone
(407) 296-1940
Fax
(407) 296-1942
NPI assigned
Dec 21, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2009

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

Authorized official

Name
Dr. Bennett M Rosenthal, M.S.,PH.D,M.D.NPI 1457337503
Title
Provider/Owner
Phone
(407) 296-1940

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
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X Primary

Addresses

Primary practice location

10000 W Colonial Dr
Suite 289
Ocoee, FL 34761-3498

Mailing address

PO Box 1909
Windermere, FL 34786-1909
Phone (407) 296-1940

Other identifiers 2

IdentifierTypeStateIssuer
376814700MedicaidFL
26248OtherFLBCBSOFFLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090804000649 FL Part B Supplier - Clinic/Group Practice 8224181524 Receives reassigned benefits from 1 practitioner
Practice locations: Ocoee, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1135123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241568000000",
    "number": "1992781041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1909",
            "city": "WINDERMERE",
            "state": "FL",
            "postal_code": "347861909",
            "telephone_number": "407-296-1940",
            "fax_number": "407-296-1942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 W COLONIAL DR",
            "address_2": "SUITE 289",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347613498",
            "telephone_number": "407-296-1940",
            "fax_number": "407-296-1942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENNETT ROSENTHAL M.S.,PH.D.,M.D.,P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-21",
        "last_updated": "2009-05-06",
        "status": "A",
        "authorized_official_last_name": "ROSENTHAL",
        "authorized_official_first_name": "BENNETT",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PROVIDER/OWNER",
        "authorized_official_telephone_number": "407-296-1940",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.S.,PH.D,M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "376814700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSOFFLA",
            "identifier": "26248",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocoee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.