MICHAEL ROSE – Foot & Ankle Surgery Podiatrist, NPI 1679144810

MICHAEL ROSE is a healthcare provider. based in Avon, Ohio. specializing in PODIATRY. They hold a License No. 59.000922 (OH). The NPI Number for MICHAEL ROSE is 1679144810

Main info

Male
5 Years Of Experience
Accepts Medicare Assignment
Name
MICHAEL ROSE
NPI
1679144810
Phone
(508) 446-5275
Address
2040 DOOVYS ST
Enumeration Date
8 July 2021
Last Update Date
8 July 2021

Doctor Profile

Medical School Name
KENT STATE UNIVERSITY COLLEGE OF PODIATRIC MEDICINE
Secondary Phone
9896673668
Graduation Year
2021 (5 years ago)
PAC ID
5294268074
Group Practice PAC ID
6507267937
Professional Enrollment ID
I20241031003614
Address ID
MI487062113BA3601XRDXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:4State licenses:1Digital endpointsOther names

953 PODIATRY in OH

Provider Addresses for MICHAEL ROSE

  • 2040 DOOVYS ST

    AVON, OH 440111116

    Phone: (508) 446-5275

    Type: Mailing

  • 2351 E 22ND ST

    CLEVELAND, OH 441153111

    Phone: (216) 861-6200

    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 $1,191.

Total Amount is formed as General ($1,191) + Research ($0) + Ownership ($0) = $1,191.

Last reported payment date: 2024-12-12 • Largest payer in this snapshot: Integra LifeSciences Corporation ($297).

Total Amount

$1,191

General + Research + Ownership

Payments

21

Total payment records

General Amount

$1,191

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-12

Latest reported date

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: 2024-10-31

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
I20241031003614IPodiatryMITBD

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 44011)

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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: 6507267937View full group profile
NameSpecialtyState
P O D I A T R YMI

Reviews

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Frequently asked questions

Is MICHAEL ROSE listed with a National Provider Identifier?
Yes — MICHAEL ROSE has NPI 1679144810 on file in the registry.
Is MICHAEL ROSE still an active registrant?
MICHAEL ROSE carries an active NPI according to the public dataset.
What expertise is attributed to MICHAEL ROSE?
MICHAEL ROSE's specialty line reads Foot & Ankle Surgery Podiatrist. Clinical services aligned with this taxonomy classification.
What locale is associated with MICHAEL ROSE?
Directory geography for MICHAEL ROSE centers on Avon, Ohio.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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