ROSENBERG ACOSTA REYES


Address: 320 West Woodlawn Ave, Louisville, KY 40214
Phone: 5023682563

ROSENBERG ACOSTA REYES (NPI# 1861465254) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1861465254
Entity Type Individual
Full Name ROSENBERG ACOSTA REYES
Credential M.D.
Practice Address 320 West Woodlawn Ave
Louisville
KY 40214
Practice Telephone 5023682563
Practice Fax Number 5023682427
Mailing Telephone 5023682563
Mailing Fax Number 5023682427
Enumeration Date 2006-02-08
Last Update Date 2016-11-30
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207Q00000X Family Medicine 35249 KY Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
KY PASSPORT PROV. ID 1158227 01
KY ANTHEM PROVIDER ID 000000209925 01
BCBS ANTHEM ID 000000209925 01
KY RR MEDICARE PROV. ID 080178783 01
KY MEDICARE PTAN 595419196 01
KY 64004104 05

Office Location

Street Address 320 WEST WOODLAWN AVE
City LOUISVILLE
State KY
Zip Code 40214

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Taxonomy Information

Taxonomy Code 207Q00000X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine

Taxonomy Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition]
- Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences.
- Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine.

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1104341171 Brandy Wells Family Medicine 11612 Top Walnut Loop, Louisville, KY 40229 2017-08-10
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Competitor

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City LOUISVILLE
Zip Code 40214

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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