DR. PETER S. ROSA (M.D.) – Family Medicine Physician, NPI 1104918630

DR. PETER S. ROSA (M.D.) is a healthcare provider. based in Hiawatha, Kansas. specializing in FAMILY PRACTICE. They hold the professional credentials M.D.. They hold a License No. 0426820 (KS). The NPI Number for DR. PETER S. ROSA (M.D.) is 1104918630

Main info

Male
31 Years Of Experience
Accepts Medicare Assignment
Name
DR. PETER S. ROSA (M.D.)
NPI
1104918630
Phone
(785) 742-2161
Address
300 UTAH, 2ND FLOOR
Enumeration Date
29 September 2006
Last Update Date
18 March 2026

Doctor Profile

Medical School Name
UNIVERSITY OF KANSAS SCHOOL OF MED (KC/WICH/SAL)
Secondary Phone
7857422131
Graduation Year
1995 (31 years ago)
PAC ID
5698725216
Group Practice PAC ID
9032007364
Professional Enrollment ID
I20050607001205
Address ID
KS664342326HI300XXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness85
Years active:19State licenses:1Digital endpointsOther names

1,421 FAMILY PRACTICE in KS

Provider Addresses for DR. PETER S. ROSA (M.D.)

  • Utah Street, Hiawatha, Brown County, Kansas, 66434, United States

    HIAWATHA, KS 664342314

    Phone: (785) 742-2161

    Fax: (785) 742-6554

    Type: Mailing

  • 415 W Main St

    Highland, KS 660354143

    Phone: (785) 442-3213

    Fax: (785) 442-5572

    Type: Location

  • 300 Utah St

    Hiawatha, KS 664342326

    Phone: (785) 742-2131

    Fax: (785) 742-6558

    Type: Location

  • 300 UTAH ST

    HIAWATHA, KS 664342326

    Phone: (785) 742-2131

    Fax: (785) 742-6558

    Type: Mailing

  • 300 UTAH ST STE 200

    HIAWATHA, KS 664342314

    Phone: (785) 742-2161

    Fax: (785) 742-6558

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 21 Open Payments records for all available years, with a total value of $406.

Total Amount is formed as General ($406) + Research ($0) + Ownership ($0) = $406.

Last reported payment date: 2024-12-04 • Largest payer in this snapshot: Vanda Pharmaceuticals Inc. ($58).

Total Amount

$406

General + Research + Ownership

Payments

21

Total payment records

General Amount

$406

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-04

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2005-06-07

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20050607001205IFamily PracticeKSTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 66434)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9032007364View full group profile
NameSpecialtyState
Certified Nurse Midwife (Cnm)KS
Nurse PractitionerKS
Nurse PractitionerKS
Family PracticeKS
Physician AssistantKS
Nurse PractitionerKS
Nurse PractitionerKS
Nurse PractitionerKS
-KS
Diagnostic RadiologyKS

Reviews

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Frequently asked questions

What is the 10-digit NPI for DR. PETER S. ROSA (M.D.)?
DR. PETER S. ROSA (M.D.) — NPI 1104918630 — is the standard way to identify this listing.
Does the file indicate DR. PETER S. ROSA (M.D.) is practicing under active NPI?
Directory data currently reports DR. PETER S. ROSA (M.D.) as active.
What taxonomy line describes DR. PETER S. ROSA (M.D.)?
For research purposes, treat DR. PETER S. ROSA (M.D.) as Family Medicine Physician in this dataset. Clinical services aligned with this taxonomy classification.
Does DR. PETER S. ROSA (M.D.) list a practice location?
Patients near Hiawatha, Kansas may find DR. PETER S. ROSA (M.D.) in results; validate coverage separately.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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