Active NPI
Nancy A Rothenberg, DO
- Pediatrics Physician
- Old Tappan, NJ
National Provider Identifier
1326056227
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MB05630800
- Practice address
- 215 Old Tappan Rd
Old Tappan, NJ 07675 - Phone
- (201) 666-1000
- Fax
- (201) 666-7610
- NPI assigned
- Aug 4, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MB05630800 | NJ | Primary |
Addresses
Primary practice location
215 Old Tappan Rd
Old Tappan, NJ 07675
Mailing address
215 Old Tappan Rd
Old Tappan Pediatrics
Old Tappan, NJ 07675
Phone (201) 666-1000
Other identifiers 14
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 221941517009 | Other | PRUDENTIAL | |
| 4241232 | Other | AETNA | |
| 58H201 | Other | EMPIRE HLTHCR | |
| 4233290 | Other | AETNA | |
| 80672 | Other | AMERIGROUP | |
| 13347 | Other | USHC | |
| 7909705 | Medicaid | NJ | |
| 8849471008 | Other | CIGNA | |
| 998604 | Other | HEALTHNET REFERRAL | |
| 23785 | Other | MASTERCARE | |
| 040056308NJ01 | Other | ANTHEM HEALTH | |
| BP197 | Other | OXFORD | |
| F01397 | Other | HEALTHNET | |
| 1979064 | Other | UNITED HLTHCR |
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
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MB05630800 | NJ | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| BCD Health Partners | Pediatrics | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Pediatrics Physician
- Woodland Park, NJ
- NPI 1225317704
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1326056227",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "215 OLD TAPPAN RD",
"address_2": "OLD TAPPAN PEDIATRICS",
"city": "OLD TAPPAN",
"state": "NJ",
"postal_code": "07675",
"telephone_number": "201-666-1000",
"fax_number": "201-666-7610"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 OLD TAPPAN RD",
"city": "OLD TAPPAN",
"state": "NJ",
"postal_code": "07675",
"telephone_number": "201-666-1000",
"fax_number": "201-666-7610"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROTHENBERG",
"first_name": "NANCY",
"middle_name": "A",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NJ",
"license": "MB05630800",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRUDENTIAL",
"identifier": "221941517009",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4241232",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE HLTHCR",
"identifier": "58H201",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4233290",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP",
"identifier": "80672",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "USHC",
"identifier": "13347",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7909705",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "8849471008",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNET REFERRAL",
"identifier": "998604",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MASTERCARE",
"identifier": "23785",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM HEALTH",
"identifier": "040056308NJ01",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD",
"identifier": "BP197",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNET",
"identifier": "F01397",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HLTHCR",
"identifier": "1979064",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Old Tappan, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.