Individual provider Active NPI

Mark William Rothstein, DPM

  • Primary Podiatric Medicine Podiatrist
  • Baltimore, MD
National Provider Identifier
1467562389
Registry record updated Jun 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
01451 Issued in MD
Practice address
6507 Edenvale Rd
Baltimore, MD 21209-3303
Phone
(410) 982-6670
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine Podiatrist 213EP1101X 01451 MD Primary

Addresses

Primary practice location

6507 Edenvale Rd
Baltimore, MD 21209-3303

Mailing address

6507 Edenvale Rd
Baltimore, MD 21209-3303
Phone (410) 982-6670

Other identifiers 2

IdentifierTypeStateIssuer
AZ0194730OtherAZBCBS
423468MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
241TXMDAddiction (Substance Use Disorder) Counselor
01451MDMDPrimary Podiatric Medicine Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Management Services, LLC Past Accepting new patients
Fort McDowell Yavapai Nation Past Accepting new patients
Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm Past Accepting new patients

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433116800000",
    "number": "1467562389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6507 EDENVALE RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212093303",
            "telephone_number": "410-982-6670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6507 EDENVALE RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212093303",
            "telephone_number": "410-982-6670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTHSTEIN",
        "first_name": "MARK",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2015-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "MD",
            "license": "01451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "AZ0194730",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "423468",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.