Individual provider Active NPI

Joshua S Rotenberg, MD

  • Neurology with Special Qualifications in Child Neurology Physician
  • Houston, TX
National Provider Identifier
1437149333
Registry record updated Dec 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
M0545 Issued in TX
Practice address
902 Frostwood Dr Ste 210
Suite 210
Houston, TX 77024-2426
Phone
(713) 464-4107
Fax
(713) 465-4522
NPI assigned
Oct 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Sleep Medicine Physician 2080S0012X M0545 TX
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X M0545 TX Primary

Addresses

Primary practice location

902 Frostwood Dr Ste 210
Suite 210
Houston, TX 77024-2426

Mailing address

902 Frostwood Drive Suite 210
Suite 210
Houston, TX 77024
Phone (713) 464-4107

Other identifiers 3

IdentifierTypeStateIssuer
1793739-03MedicaidTX
8F22536OtherTXMEDICARE- HOUSTON
8L13369OtherTXMEDICARE- SAN ANTONIO

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
I20051228000588 TX Practitioner - Pediatric MedicinePractitioner - NeurologyPractitioner - Other (Physician) 0941222392

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M0545TXMDNeurology with Special Qualifications in Child Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neurology and Sleep Specialists, PLLC CurrentSince Dec 31, 2005 Accepting new patients
Academy Diagnostics LLC CurrentSince Jun 1, 2007 Accepting new patients
Neurology and Sleep Specialists, PLLC Sleep Medicine Past Accepting new patients

Locations

902 Frostwood Dr
Ste 210
Houston, TX 77024
Phone (713) 464-4107

525 Oak Centre Dr
Ste 400
San Antonio, TX 78258
Phone (210) 299-3922

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.

NPI Registry JSON

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

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481846400000",
    "number": "1437149333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 FROSTWOOD DRIVE SUITE 210",
            "address_2": "SUITE 210",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77024",
            "telephone_number": "713-464-4107",
            "fax_number": "713-465-4522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 FROSTWOOD DR STE 210",
            "address_2": "SUITE 210",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770242426",
            "telephone_number": "713-464-4107",
            "fax_number": "713-465-4522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTENBERG",
        "first_name": "JOSHUA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-24",
        "last_updated": "2016-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080S0012X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sleep Medicine",
            "state": "TX",
            "license": "M0545",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "TX",
            "license": "M0545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1793739-03",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE- HOUSTON",
            "identifier": "8F22536",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE- SAN ANTONIO",
            "identifier": "8L13369",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.