Stacey Anne Rotta, M.D.

Primary specialty

Surgical Critical Care PhysicianTaxonomy code 2086S0102X

License

MD23505 Issued in ME

Practice address

887 Congress St
Portland, ME 04102-3100

Phone

(207) 774-6368

NPI assigned

Jun 10, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: srotta258678@direct.valleywisehealth.org

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.

• District Medical Group, Inc

  • Anatomic Pathology & Clinical Pathology Physician
  • Phoenix, AZ
  • NPI 1336472448
  NPD

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

{
    "created_epoch": "1339286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584921600000",
    "number": "1093077703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "887 CONGRESS ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023100",
            "telephone_number": "207-774-6368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "887 CONGRESS ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023100",
            "telephone_number": "207-774-6368"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1450 Chapel St",
            "address_2": "Hospital of Saint Raphael General Surgery Department",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065114405",
            "country_code": "US",
            "telephone_number": "203-789-3443",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2315 Stockton Blvd",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958172201",
            "country_code": "US",
            "telephone_number": "408-318-0044",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROTTA",
        "first_name": "STACEY",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-10",
        "last_updated": "2020-03-23",
        "certification_date": "2020-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "CA",
            "license": "A156409",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "ME",
            "license": "MD23505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Rota, LSW
• Barbara Price Roth, LCPC
• Charles J. Roth, PA-C
• Debra A Rothenberg, M.D.
• Rute S Rothwell, MD
• Bruce Glenn Rottmann, MD
• Leslie Roub
• James H Rough, PSYD
• Cindy M. Rounds, LCPC
• Margarett J Rounsavall

• Surgical Critical Care Physician in Portland, ME
• Providers in Portland, ME by specialty
• Surgical Critical Care Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2020; 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.