Andreas D. Rotsides, MD, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25MA05010400 Issued in NJ

Legal business name

ANDREAS D. ROTSIDES, MD, LLC

Practice address

195 US Highway 46
Suite 200
Mine Hill, NJ 07803-3163

Phone

(973) 328-1040

Fax

(973) 328-1544

NPI assigned

Apr 16, 2006

Last updated

Sep 8, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Andreas D Rotsides, MDNPI 1295799153

Title

Owner

Phone

(973) 328-1040

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Andreas D Rotsides, M.D.

  • Internal Medicine Physician
  • Mine Hill, NJ
  • NPI 1295799153
  Medicare reassignment NPD Authorized official
• Kathleen A Maher, FNP

  • Family Nurse Practitioner
  • Morris Plains, NJ
  • NPI 1720107774
  Medicare reassignment NPD

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

{
    "created_epoch": "1145145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252368000000",
    "number": "1104880061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 US HIGHWAY 46",
            "address_2": "SUITE 200",
            "city": "MINE HILL",
            "state": "NJ",
            "postal_code": "078033163",
            "telephone_number": "973-328-1040",
            "fax_number": "973-328-1544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 US HIGHWAY 46",
            "address_2": "SUITE 200",
            "city": "MINE HILL",
            "state": "NJ",
            "postal_code": "078033163",
            "telephone_number": "973-328-1040",
            "fax_number": "973-328-1544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDREAS D. ROTSIDES, MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-16",
        "last_updated": "2009-09-08",
        "status": "A",
        "authorized_official_last_name": "ROTSIDES",
        "authorized_official_first_name": "ANDREAS",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-328-1040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA05010400",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NJ",
            "license": "25MA05010400",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH GROUP ID",
            "identifier": "2352899001",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GRP",
            "identifier": "DG4164",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0077241",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Mine Hill, NJ
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• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.