Active NPI
Derald W Rochat, M.D.
- Otolaryngology Physician
- Placerville, CA
National Provider Identifier
1295752129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- G25083
- Practice address
- 1008 Fowler Way
Suite C
Placerville, CA 95667-5701 - Phone
- (530) 622-1283
- Fax
- (530) 622-0283
- NPI assigned
- Jul 16, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | G25083 | CA | Primary |
Addresses
Primary practice location
1008 Fowler Way
Suite C
Placerville, CA 95667-5701
Mailing address
1008 Fowler Way Ste C
Placerville, CA 95667-5701
Phone (916) 676-1450
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G250830 | Medicaid | CA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| G25083 | CA | MD | Otolaryngology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1289433600000",
"number": "1295752129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1008 FOWLER WAY STE C",
"city": "PLACERVILLE",
"state": "CA",
"postal_code": "956675701",
"telephone_number": "916-676-1450",
"fax_number": "916-676-1447"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1008 FOWLER WAY",
"address_2": "SUITE C",
"city": "PLACERVILLE",
"state": "CA",
"postal_code": "956675701",
"telephone_number": "530-622-1283",
"fax_number": "530-622-0283"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROCHAT",
"first_name": "DERALD",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-16",
"last_updated": "2010-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "CA",
"license": "G25083",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G250830",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Placerville, CA
- Kathleen Robertson, PHN
- Mari Lorraine Robertson
- Robinson'S Pharmacy & Medical Supplies, Inc.
- Robinson'S Pharmacy & Medical Supplies, Inc.
- Amy Merary Robles, PA-C
- Rock Solid Athletics & Rehab
- Haley Rodriguez, MS, PPS
- Michelle Rodriguez, BACHELORS OF SCIENCE
- Rachel Brooke Rodriguez
- Tonantzin Eva Rodriguez, MD, MPH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.