Individual provider Active NPI

Bennett Charles Rothenberg, M.D.

  • Specialist
  • Livingston, NJ
National Provider Identifier
1154481281
Registry record updated Mar 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA52367 Issued in NJ
Practice address
22 Old Short Hills Rd
Suite 101
Livingston, NJ 07039-5604
Phone
(973) 994-3311
Fax
(973) 994-7005
NPI assigned
Dec 11, 2006
Last updated
Mar 3, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA52367 NJ Primary

Addresses

Primary practice location

22 Old Short Hills Rd
Suite 101
Livingston, NJ 07039-5604

Mailing address

22 Old Short Hills Rd
Suite 101
Livingston, NJ 07039-5604
Phone (973) 994-3311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110329000014 NJ Practitioner - Plastic and Reconstructive Surgery 5092998021 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Howard University College of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

22 Old Short Hills Rd
Suite 101
Livingston, NJ 07039-5605
Phone (973) 994-3311

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy19
Melanoma (skin cancer) excision26
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MA52367NJMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Bennett C. Rothenberg, M.D., F.a.C.S., L.L.C. CurrentSince Nov 27, 2010 Accepting new patients

Locations

22 Old Short Hills Rd
Ste 101
Livingston, NJ 07039
Phone (973) 597-9005

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299110400000",
    "number": "1154481281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 OLD SHORT HILLS RD",
            "address_2": "SUITE 101",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070395604",
            "telephone_number": "973-994-3311",
            "fax_number": "973-994-7005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 OLD SHORT HILLS RD",
            "address_2": "SUITE 101",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070395604",
            "telephone_number": "973-994-3311",
            "fax_number": "973-994-7005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTHENBERG",
        "first_name": "BENNETT",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2011-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "MA52367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livingston, NJ

Sources for this page

Verify at the official NPI Registry.