Kenneth M. Rose, M.D., PLLC
NPI 1770711301ActiveOrganization· PACE Provider Organization· New York, NY
PACE Provider Organization in New York, New York, registered in NPPES in June 2009. The authorized official on file is Juanita Butler, Office Manager. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1770711301 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 22, 2009 |
| Last updated in NPPES | Jun 22, 2009 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| PACE Provider Organization Primary | 251T00000X | 188699-1 | NY |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (NY) |
|---|
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