Individual provider Active NPI

Joseph David Rotella, M.D.

  • Internal Medicine Physician
  • Louisville, KY
National Provider Identifier
1407952443
Registry record updated Jul 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
34987 Issued in KY
Practice address
3532 Ephraim McDowell Dr
Louisville, KY 40205-3224
Phone
(502) 719-4142
Fax
(502) 456-6655
NPI assigned
Sep 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 34987 KY Primary
Internal Medicine Physician 207R00000X 01060120A IN

Addresses

Primary practice location

3532 Ephraim McDowell Dr
Louisville, KY 40205-3224

Mailing address

3532 Ephraim McDowell Dr
Louisville, KY 40205-3224
Phone (502) 719-4142

Other identifiers 2

IdentifierTypeStateIssuer
200421560MedicaidIN
6401223000MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20130517000113 KY Order and Referring Only - Hospice/Palliative CarePractitioner - Hospice/Palliative Care 8729038765

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34987KYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hosparus Palliative Care Inc. Internal Medicine 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404777600000",
    "number": "1407952443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3532 EPHRAIM MCDOWELL DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402053224",
            "telephone_number": "502-719-4142",
            "fax_number": "502-456-6655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3532 EPHRAIM MCDOWELL DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402053224",
            "telephone_number": "502-719-4142",
            "fax_number": "502-456-6655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTELLA",
        "first_name": "JOSEPH",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2014-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "34987",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01060120A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200421560",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6401223000",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.