Individual provider Active NPI

Rosser Kennedy Powitzky, MD

  • Pediatric Otolaryngology Physician
  • Temple, TX
National Provider Identifier
1386840692
Registry record updated Jan 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Otolaryngology PhysicianTaxonomy code 207YP0228X
License
P5710 Issued in TX
Practice address
2401 S 31St St
Ms-09-C400C
Temple, TX 76508-0001
Phone
(254) 724-4541
NPI assigned
Jun 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X P5710 TX
Pediatric Otolaryngology Physician 207YP0228X P5710 TX Primary

Addresses

Primary practice location

2401 S 31St St
Ms-09-C400C
Temple, TX 76508-0001

Mailing address

PO Box 844658
Dallas, TX 75284-4658

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rpowitzky26560@direct.sw.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130828000246 TX Practitioner - OtolaryngologyPractitioner - Pediatric Medicine 5799928479 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Pediatric Medicine
Education
Texas Tech University Health Science Center School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scott and White ClinicGroup PAC ID 8123923604, 2,426 clinicians

Practice addresses (Care Compare)

1605 S 31St St
Baylor Scott and White Center for Dia
Temple, TX 76508-0001
Phone (254) 215-0100

1901 SW H K Dodgen Loop
Temple, TX 76502-1814
Phone (254) 724-5437

1901 SW H K Dodgen LP BLDG
300 Baylor Scott and White McLane Childre
Temple, TX 76502-1814
Phone (254) 724-5437

2401 S 31 St
Temple, TX 76508-0001
Phone (254) 724-2459

2401 S 31St St BLDG
35 Baylor Scott and White Roney Bone and
Temple, TX 76508-0001
Phone (254) 724-2663

810 W U Ave
Temple, TX 76508-0001
Phone (254) 724-2585

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
P5710TXMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scott & White Clinic Otolaryngology CurrentSince Jul 15, 2013 Accepting new patients
Scott & White Clinic Otolaryngology CurrentSince Jul 15, 2013 Accepting new patients
Scott & White Hospital - Taylor Past Accepting new patients

Locations

101 Lafferty Ave
Cameron, TX 76520
Phone (254) 605-1100

2401 S 31st St
#9C400C
Temple, TX 76508
Phone (254) 724-4689

1901 SW H K Dodgen Loop
Bldg 300
Temple, TX 76502
Phone (254) 935-4888

2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459

Interoperability endpoints

  • Direct secure messaging: rpowitzky26560@direct.sw.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1182556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609804800000",
    "number": "1386840692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 S 31ST ST",
            "address_2": "MS-09-C400C",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765080001",
            "telephone_number": "254-724-4541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWITZKY",
        "first_name": "ROSSER",
        "middle_name": "KENNEDY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-23",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "P5710",
            "primary": false
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "TX",
            "license": "P5710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rpowitzky26560@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2401 S 31st St",
            "address_2": "MS-09-C400C",
            "city": "Temple",
            "state": "TX",
            "country_code": "US",
            "postal_code": "765080001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Temple, TX

Sources for this page

Verify at the official NPI Registry.