Active NPI
Rosalie Bortnick
- Speech-Language Pathologist
- Gaithersburg, MD
National Provider Identifier
1265994149
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 06419
- Practice address
- 18425 Flower Hill Way
Gaithersburg, MD 20879-4600 - Phone
- (301) 840-7161
- NPI assigned
- Apr 1, 2019
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 06419 | MD | Primary |
Addresses
Primary practice location
18425 Flower Hill Way
Gaithersburg, MD 20879-4600
Mailing address
850 Hungerford Dr
Rockville, MD 20850-1718
Phone (301) 840-7161
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 06419 | Medicaid | MD |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 06419 | MD | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554076800000",
"number": "1265994149",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "850 HUNGERFORD DR",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208501718",
"telephone_number": "301-840-7161"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18425 FLOWER HILL WAY",
"city": "GAITHERSBURG",
"state": "MD",
"postal_code": "208794600",
"telephone_number": "301-840-7161"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BORTNICK",
"first_name": "ROSALIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-04-01",
"last_updated": "2019-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MD",
"license": "06419",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "06419",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gaithersburg, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.