Individual provider Active NPI

Rebecca Rothbaum, PSY.D.

  • Prescribing (Medical) Psychologist
  • New Orleans, LA
National Provider Identifier
1245500404
Registry record updated Jun 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prescribing (Medical) PsychologistTaxonomy code 103TP0016X
License
307547 Issued in LA
Practice address
200 Henry Clay Ave
New Orleans, LA 70118-5720
Phone
(504) 896-9484
NPI assigned
Jan 5, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Prescribing (Medical) Psychologist 103TP0016X 307547 LA Primary
Clinical Neuropsychologist 103G00000X 1196 LA

Addresses

Primary practice location

200 Henry Clay Ave
New Orleans, LA 70118-5720

Mailing address

200 Henry Clay Ave
New Orleans, LA 70118-5720

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121108000484 LA Practitioner - Clinical Psychologist 5496906059 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Children'S HospitalGroup PAC ID 8022207745, 20 clinicians

Practice addresses (Care Compare)

200 Henry Clay Ave
New Orleans, LA 70118-5720
Phone (504) 896-9745

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
307547LAMDPrescribing (Medical) Psychologist
1196LAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital CurrentSince Jun 26, 2017 Accepting new patients

Locations

200 Henry Clay Ave
New Orleans, LA 70118
Phone (504) 412-1860

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1325721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622764800000",
    "number": "1245500404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HENRY CLAY AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701185720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HENRY CLAY AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701185720",
            "telephone_number": "504-896-9484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTHBAUM",
        "first_name": "REBECCA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-05",
        "last_updated": "2021-06-04",
        "certification_date": "2021-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TP0016X",
            "taxonomy_group": "",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "LA",
            "license": "307547",
            "primary": true
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "LA",
            "license": "1196",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.