Organization Active NPI

Fabienne Rottenberg

  • Foot & Ankle Surgery Podiatrist
  • New York, NY
National Provider Identifier
1306180187
Registry record updated Nov 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
FABIENNE ROTTENBERG
Practice address
285 West End Ave.
4Y
New York, NY 10023-2618
Phone
(212) 724-4457
Fax
(212) 362-9896
NPI assigned
Nov 19, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2012

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

Authorized official

Name
Dr. Fabienne Rottenberg, DPM
Title
Owner
Phone
(212) 724-4457

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X Primary

Addresses

Primary practice location

285 West End Ave.
4Y
New York, NY 10023-2618

Mailing address

285 West End Ave.
4Yw
New York, NY 10023-2618
Phone (212) 724-4457

Other identifiers 1

IdentifierTypeStateIssuer
01076360MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930091169 NY DME Supplier - Physician - Podiatry 7416078308 1 other NPI on this enrollment
Practice locations: New York, NY

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

285 W End Ave
Ste 4YW
New York, NY 10023
Phone (212) 724-4457

NPI Registry JSON

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

{
    "created_epoch": "1353283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353283200000",
    "number": "1306180187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 WEST END AVE.",
            "address_2": "4YW",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100232618",
            "telephone_number": "212-724-4457",
            "fax_number": "212-362-9896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 WEST END AVE.",
            "address_2": "4Y",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100232618",
            "telephone_number": "212-724-4457",
            "fax_number": "212-362-9896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FABIENNE ROTTENBERG",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-19",
        "last_updated": "2012-11-19",
        "status": "A",
        "authorized_official_last_name": "ROTTENBERG",
        "authorized_official_first_name": "FABIENNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-724-4457",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01076360",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.