Active NPI
Robert Edmund Tortolani, M.D.
- Family Medicine Physician
- Brattleboro, VT
National Provider Identifier
1245285667
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 042-0004283
- Practice address
- 63 Belmont Ave
Suite 1
Brattleboro, VT 05301-6614 - Phone
- (802) 254-1113
- NPI assigned
- May 24, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 042-0004283 | VT | Primary |
Addresses
Primary practice location
63 Belmont Ave
Suite 1
Brattleboro, VT 05301-6614
Mailing address
63 Belmont Ave
Suite 1
Brattleboro, VT 05301-6614
Phone (802) 254-1113
Other identifiers 15
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00004509 | Other | VT | BLUE CROSS BLUE SHIELD |
| 0107454YPVT01 | Other | ANTHEM | |
| 2436727 | Other | AETNA | |
| 63E51 | Other | EMPIRE BCBS | |
| 0004509 | Medicaid | VT | |
| 710793 | Other | TUFTS | |
| 101335600 | Other | U.S. DEPT. OF LABOR | |
| 99903023 | Medicaid | NH | |
| B85462 | Other | HARVARD PILGRIM OF N.E. | |
| B85462 | Other | TODAYS OPTIONS | |
| 030236149 | Other | CIGNA HEALTHCARE | |
| 082092003 | Other | RAILROAD MEDICARE | |
| 08P019 | Other | MVP | |
| 030236149 | Other | TRICARE | |
| 8000388 | Other | VT | LADIES FIRST |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080122000199 | VT | Practitioner - Family Practice | 3779664354 | Practice locations: Brattleboro, VT; Vernon, VT |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 042-0004283 | VT | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1257811200000",
"number": "1245285667",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "63 BELMONT AVE",
"address_2": "SUITE 1",
"city": "BRATTLEBORO",
"state": "VT",
"postal_code": "053016614",
"telephone_number": "802-254-1113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "63 BELMONT AVE",
"address_2": "SUITE 1",
"city": "BRATTLEBORO",
"state": "VT",
"postal_code": "053016614",
"telephone_number": "802-254-1113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TORTOLANI",
"first_name": "ROBERT",
"middle_name": "EDMUND",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-24",
"last_updated": "2009-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "VT",
"license": "042-0004283",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "00004509",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "0107454YPVT01",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "2436727",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE BCBS",
"identifier": "63E51",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0004509",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "710793",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "U.S. DEPT. OF LABOR",
"identifier": "101335600",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "99903023",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM OF N.E.",
"identifier": "B85462",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TODAYS OPTIONS",
"identifier": "B85462",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA HEALTHCARE",
"identifier": "030236149",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "082092003",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MVP",
"identifier": "08P019",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "030236149",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LADIES FIRST",
"identifier": "8000388",
"state": "VT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brattleboro, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.