Active NPI
Romina Tollerutti, M.D.
- Pediatrics Physician
- Missoula, MT
National Provider Identifier
1346570975
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 266037
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 266037 | NY | MD | Pediatrics 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.