HOLLY SAMANTHA ROSE MD
NPI 1770074684
Pediatrics in Indianapolis, IN

Q: What is Holly Rose's NPI number?

The NPI number for Holly Rose is 1770074684. It was assigned to this individual provider in the NPPES registry on May 25, 2018.

Q: What is Holly Rose's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Holly Rose was last updated on March 5, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 25, 2018PECOS Enrolled

705 RILEY HOSPITAL DR, INDIANAPOLIS, IN 46202(317) 944-5000 Get Directions Write a Review

NPPES record last updated: March 5, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 5, 2025, Nov 8, 2024, Jan 13, 2022 and 1 more (4 updates tracked since 2018).

On this page

About Holly Samantha Rose Md NPPES

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

HOLLY SAMANTHA ROSE MD (NPI 1770074684) is an individual pediatrics provider in Indianapolis, Indiana, licensed in Indiana (01087524A) and active in the NPI registry since May 2018. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1770074684

Entity TypeIndividualFemale

Primary Taxonomy208000000X

Provider Legal NameHOLLY SAMANTHA ROSECredential: MD

Location Address705 RILEY HOSPITAL DRIndianapolis, IN 46202-5109

Mailing Address705 Riley Hospital DrIndianapolis, IN 46202-5109

Phone(317) 944-5000

Sole ProprietorNo

Enumeration DateMay 25, 2018

Last NPPES UpdateMarch 5, 20254 updates tracked since enumeration

NPPES CertifiedMarch 5, 2025

✔ NPI 1770074684 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

Licenses✔ Licensed in IN · 01087524A✔ Licensed in SC · MMD.52452.LL

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

705 RILEY HOSPITAL DR, Indianapolis, IN 46202

Open in Google Maps ↗

Secondary Practice Locations 2

Location 1169 Ashley Ave, Room 202 Main Hospital, MSC 333Charleston, SC 29425 · Phone (843) 792-8972

Location 21701 N Senate BlvdIndianapolis, IN 46202-1239 · Phone (888) 484-3258

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, First Choice Next.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Holly Samantha Rose Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 46202 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

$82.04 typical visit price

range $53.07 – $161.76

Typical copayment $20.51 (range $13.26 – $40.44)

Most-billed visit code 99203

Established Patient

$94.22 typical visit price

range $16.93 – $132.22

Typical copayment $23.55 (range $4.23 – $33.05)

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.

Leave this field empty

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.

MOHANNAD MOALLEM M.D.

Pediatrics (Neonatal-Perinatal Medicine)