Individual provider Active NPI

Mary Mathews Rotto, PAC

  • Obstetrics & Gynecology Physician
  • Ames, IA
National Provider Identifier
1417939638
Registry record updated Jul 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
00870 Issued in IA
Practice address
1015 Duff Ave
Ames, IA 50010-5733
Phone
(515) 239-6970
Fax
(515) 239-6950
NPI assigned
Nov 15, 2005
Last updated
Jul 30, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 00870 IA Primary

Addresses

Primary practice location

1015 Duff Ave
Ames, IA 50010-5733

Mailing address

1015 Duff Ave
Ames, IA 50010-5733
Phone (515) 239-6970

Other identifiers 1

IdentifierTypeStateIssuer
0150599MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051123000147 IA Practitioner - Physician Assistant 4688694433 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Doran and Doran PCGroup PAC ID 1456241983, 6 clinicians

Practice addresses (Care Compare)

1015 Duff Ave
Suite 100
Ames, IA 50010-5733
Phone 51523969704769

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
000870IAMDOccupational Therapy Assistant
9550MNMDFamily Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375142400000",
    "number": "1417939638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 DUFF AVE",
            "city": "AMES",
            "state": "IA",
            "postal_code": "500105733",
            "telephone_number": "515-239-6970",
            "fax_number": "515-239-6950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 DUFF AVE",
            "city": "AMES",
            "state": "IA",
            "postal_code": "500105733",
            "telephone_number": "515-239-6970",
            "fax_number": "515-239-6950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTTO",
        "first_name": "MARY",
        "middle_name": "MATHEWS",
        "name_prefix": "Mrs.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-15",
        "last_updated": "2013-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IA",
            "license": "00870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0150599",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ames, IA

Sources for this page

Verify at the official NPI Registry.