NPIMap

Individual provider Active NPI

Lori G Rollwitz, PA-C, MPAS

  • Physician Assistant
  • Boerne, TX
National Provider Identifier
1003079609
Registry record updated Jul 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA05367 Issued in TX
Practice address
34910 Interstate 10 W
Suite 301
Boerne, TX 78006-9229
Phone
(830) 816-3838
Fax
(830) 816-3833
NPI assigned
Jul 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA05367 TX Primary

Addresses

Primary practice location

34910 Interstate 10 W
Suite 301
Boerne, TX 78006-9229

Mailing address

34910 Interstate 10 W
Suite 301
Boerne, TX 78006-9229
Phone (830) 816-3838

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PA05367TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Sinus Center, P.a. PastSince Jan 1, 2003 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1215043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215043200000",
    "number": "1003079609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34910 INTERSTATE 10 W",
            "address_2": "SUITE 301",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780069229",
            "telephone_number": "830-816-3838",
            "fax_number": "830-816-3833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34910 INTERSTATE 10 W",
            "address_2": "SUITE 301",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780069229",
            "telephone_number": "830-816-3838",
            "fax_number": "830-816-3833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLLWITZ",
        "first_name": "LORI",
        "middle_name": "G",
        "name_prefix": "Ms.",
        "credential": "PA-C, MPAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-03",
        "last_updated": "2008-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA05367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boerne, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.