DR. JACK A. ROSENBERG M. D. NPI 1790748556

NPI Information

  • NPI: 1790748556
  • Provider Name: DR. JACK A. ROSENBERG, M. D.
  • Classification: Pediatrics - 2080A0000X
  • Specialization: Adolescent Medicine
  • Entity Type: Individual
  • Address: 5920 N. E. RAY CIRCLE
    SUITE 220
    HILLSBORO, OR
    ZIP 97124
  • Phone: (503) 690-0707

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NPI Details

DR. Jack A. Rosenberg, M. D. is an adolescent medicine pediatrics in Hillsboro, OR. The provider is a pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. DR. Jack A. Rosenberg, M. D. NPI is 1790748556. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

5920 N. E. RAY CIRCLE
SUITE 220
HILLSBORO, OR
ZIP 97124-313
Phone: (503) 690-0707
Fax: (503) 690-9796

The enumeration date for this NPI number is 4/11/2006 and was last updated on 4/28/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208000000XPediatricsMD08402OREGONNo
22080P0202XPediatricsPediatric CardiologyMD08402OREGONNo
32080A0000XPediatricsAdolescent MedicineMD08402OREGONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1164012MEDICARE ID-TYPE UNSPECIFIEDOREGON
2164012MEDICAIDOREGON
3G31345MEDICARE UPINOREGON
4G31345MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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