DR. JONATHAN DALE ROSENBOOM PSY.D.
NPI 1679716864
Psychologist - Clinical in Warsaw, MO

Q: What is Jonathan Rosenboom's NPI number?

The NPI number for Jonathan Rosenboom is 1679716864. It was assigned to this individual provider in the NPPES registry on April 17, 2009.

Q: What is Jonathan Rosenboom's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Active since April 17, 2009PECOS EnrolledAccepts Medicare Assignment

17571 N DAM ACCESS RD, WARSAW, MO 65355(888) 403-1071 Get Directions Write a Review

NPPES record last updated: March 18, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 18, 2020, Oct 19, 2018 (2 updates tracked since 2018).

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About Dr. Jonathan Dale Rosenboom Psy.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JONATHAN DALE ROSENBOOM PSY.D. (NPI 1679716864) is an individual clinical provider in Warsaw, Missouri, licensed in Missouri (01221) and active in the NPI registry since April 2009. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (1984).

NPPES Registry Identity

NPI1679716864

Entity TypeIndividualMale

Primary Taxonomy103TC0700X

Provider Legal NameDR. JONATHAN DALE ROSENBOOMCredential: PSY.D.

Location Address17571 N DAM ACCESS RDWarsaw, MO 65355

Mailing Address1800 CommunityClinton, MO 64735-8804 · (660) 885-8131

Phone(888) 403-1071

Sole ProprietorNo

Medical School CMSOtherGraduated 1984

Enumeration DateApril 17, 2009

Last NPPES UpdateMarch 18, 20202 updates tracked since enumeration

NPPES CertifiedMarch 18, 2020

✔ NPI 1679716864 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in MO · 01221

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

17571 N DAM ACCESS RD, Warsaw, MO 65355

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Secondary Practice Locations 2

Location 11901 N Westwood Blvd, Suite 5Poplar Bluff, MO 63901-2800 · Phone (573) 680-6509 · Fax (573) 760-0201

Location 2616 Burkarth RdWarrensburg, MO 64093-1462 · Phone (888) 403-1071

Other Identifiers 1

Other0076557MO · Missouri Office Of Administration

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Jonathan Dale Rosenboom Psy.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID648462531

PECOS Enrollment IDI20101011000700

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 65355 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$161.24 typical visit price

range $52.28 – $161.24

Typical copayment $40.31 (range $13.07 – $40.31)

Most-billed visit code 99205

Established Patient

$93.24 typical visit price

range $16.30 – $131.05

Typical copayment $23.31 (range $4.07 – $32.76)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

REGIONAL HEALTH CARE CLINIC INC

Clinic/Center (Federally Qualified Health Center (FQHC))