Individual provider Active NPI

Melanie Wachtel Rotenberg, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Palm Bay, FL
National Provider Identifier
1124023866
Registry record updated Sep 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
ME 65926 Issued in FL
Practice address
4650 Lipscomb St NE
Suite 14
Palm Bay, FL 32905-2997
Phone
(321) 327-2274
Fax
(321) 327-2848
NPI assigned
Jun 18, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X ME 65926 FL Primary

Addresses

Primary practice location

4650 Lipscomb St NE
Suite 14
Palm Bay, FL 32905-2997

Mailing address

PO Box 61615
Palm Bay, FL 32906-1615
Phone (321) 327-2274

Other identifiers 1

IdentifierTypeStateIssuer
25259XOtherFLMEDICARE

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME 65926FLMDPhysical Medicine & Rehabilitation Physician

NPI Registry JSON

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

{
    "created_epoch": "1119052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411084800000",
    "number": "1124023866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 61615",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329061615",
            "telephone_number": "321-327-2274",
            "fax_number": "321-327-2848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 LIPSCOMB ST NE",
            "address_2": "SUITE 14",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329052997",
            "telephone_number": "321-327-2274",
            "fax_number": "321-327-2848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTENBERG",
        "first_name": "MELANIE",
        "middle_name": "WACHTEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-18",
        "last_updated": "2014-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "ME 65926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "25259X",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Bay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2014; 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.