NPIMap

Individual provider Active NPI

Michael E Robertello, M.D.

  • Cardiovascular Disease Physician
  • Rutland, VT
National Provider Identifier
1447213384
Registry record updated Nov 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
042-0009256 Issued in VT
Practice address
12 Commons St
Rutland, VT 05701-4651
Phone
(802) 747-3600
Fax
(802) 773-8501
NPI assigned
Apr 11, 2006
Last updated
Nov 13, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 042-0009256 VT Primary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 042-0009256 VT
Nuclear Cardiology Physician 207UN0901X 042-0009256 VT

Addresses

Primary practice location

12 Commons St
Rutland, VT 05701-4651

Mailing address

12 Commons St
Rutland, VT 05701-4651
Phone (802) 747-3600

Other practice location 1

160 Allen St
Rutland, VT 05701-4560
Phone (802) 775-7111

Other identifiers 4

IdentifierTypeStateIssuer
1824753OtherCIGNA
0VN1371MedicaidVT
351070OtherMVP
28918OtherVTBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060405000214 VT Practitioner - Cardiovascular Disease (Cardiology) 3577529544 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rutland Hospital, Inc.Group PAC ID 7214846377, 186 clinicians

Practice addresses (Care Compare)

12 Commons St
Rutland, VT 05701-4651
Phone (802) 747-3600

160 Allen St
Rutland, VT 05701-4560
Phone (802) 775-7111

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
042-0009256VTMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rutland Hospital, Inc. Current Accepting new patients
Rutland Hospital, Inc Current Accepting new patients
Rutland Hospital, Inc. Current Accepting new patients
Rutland Hospital, Inc. CurrentSince Feb 20, 1996 Accepting new patients
Rutland Hospital, Inc. CurrentSince Feb 20, 1996 Accepting new patients
Vermont Physicians Clinic PastSince Nov 4, 2004 Accepting new patients
Rutland Regional Health Services Cardiovascular Disease Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

115 Porter Dr
Middlebury, VT 05753
Phone (802) 388-4701

1 Commons St
Rutland, VT 05701
Phone (802) 747-1857

12 Commons St
Rutland, VT 05701
Phone (802) 747-3600

160 Allen St
Rutland, VT 05701

6 Commons St
Rutland, VT 05701
Phone (802) 773-1128

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/6f43d0e7-6ff2-489b-abdc-44e8a5e0ca0a/

Organizations & group practices 8

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 6

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": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542067200000",
    "number": "1447213384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 COMMONS ST",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014651",
            "telephone_number": "802-747-3600",
            "fax_number": "802-773-8501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 COMMONS ST",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014651",
            "telephone_number": "802-747-3600",
            "fax_number": "802-773-8501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "160 Allen St",
            "address_purpose": "LOCATION",
            "city": "Rutland",
            "state": "VT",
            "postal_code": "057014560",
            "country_code": "US",
            "telephone_number": "802-775-7111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTELLO",
        "first_name": "MICHAEL",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2018-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "VT",
            "license": "042-0009256",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "VT",
            "license": "042-0009256",
            "primary": false
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "VT",
            "license": "042-0009256",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1824753",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0VN1371",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "351070",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "28918",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rutland, VT

Sources for this page

Verify at the official NPI Registry.