Individual provider Active NPI

Rogelio M Pine, M.D.

  • Cardiovascular Disease Physician
  • Princeton, NJ
National Provider Identifier
1366472151
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
25MA02760400 Issued in NJ
Practice address
253 Witherspoon St FL 2
Lamnert House, Medical Ctr at Princeton
Princeton, NJ 08540-3211
Phone
(609) 497-4301
Fax
(609) 497-4992
NPI assigned
Jul 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 25MA02760400 NJ Primary

Addresses

Primary practice location

253 Witherspoon St FL 2
Lamnert House, Medical Ctr at Princeton
Princeton, NJ 08540-3211

Mailing address

3626 US Highway 1
Princeton, NJ 08540-5922
Phone (609) 243-0445

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

LicenseStateTypeSpecialty
25MA02760400NJMDCardiovascular Disease Physician

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366472151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3626 US HIGHWAY 1",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085405922",
            "telephone_number": "609-243-0445",
            "fax_number": "609-452-7577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "253 WITHERSPOON ST FL 2",
            "address_2": "LAMNERT HOUSE, MEDICAL CTR AT PRINCETON",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085403211",
            "telephone_number": "609-497-4301",
            "fax_number": "609-497-4992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINE",
        "first_name": "ROGELIO",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NJ",
            "license": "25MA02760400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, 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.

Verify at the official NPI Registry.