Individual provider Active NPI

Romina Tollerutti, M.D.

  • Pediatrics Physician
  • Missoula, MT
National Provider Identifier
1346570975
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
266037 Issued in NY
Practice address
4024 Lexington Ave
Missoula, MT 59808-5665
Phone
(347) 610-2634
NPI assigned
Jan 4, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obesity Medicine (Preventive Medicine) Physician 2083B0002X 266037 NY
Pediatrics Physician 208000000X 266037 NY Primary

Addresses

Primary practice location

4024 Lexington Ave
Missoula, MT 59808-5665

Mailing address

4024 Lexington Ave
Missoula, MT 59808-5665
Phone (347) 610-2634

Other practice location 1

27 Greenfield Manor Rd
Porter Corners, NY 12859-1835
Phone (347) 610-2634

Other practice location 2

31 Burnham Rd
Wilton, NY 12831-1272
Phone (347) 610-2634

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 Medicine

State licenses

LicenseStateTypeSpecialty
266037NYMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1262563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1346570975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4024 LEXINGTON AVE",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598085665",
            "telephone_number": "347-610-2634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4024 LEXINGTON AVE",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598085665",
            "telephone_number": "347-610-2634"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27 Greenfield Manor Rd",
            "address_purpose": "LOCATION",
            "city": "Porter Corners",
            "state": "NY",
            "postal_code": "128591835",
            "country_code": "US",
            "telephone_number": "347-610-2634",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "31 Burnham Rd",
            "address_purpose": "LOCATION",
            "city": "Wilton",
            "state": "NY",
            "postal_code": "128311272",
            "country_code": "US",
            "telephone_number": "347-610-2634",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TOLLERUTTI",
        "first_name": "ROMINA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-04",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083B0002X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Obesity Medicine",
            "state": "NY",
            "license": "266037",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "266037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.