Active NPI
Marc Matthew Rothberg, RPH
- Pharmacist
- Carmel, NY
National Provider Identifier
1508012642
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 031010-1
- Practice address
- 180 Gleneida Avenue
Carmel, NY 10512-1211 - Phone
- (845) 225-1038
- Fax
- (845) 228-0257
- NPI assigned
- Aug 8, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 031010-1 | NY | Primary |
Addresses
Primary practice location
180 Gleneida Avenue
Carmel, NY 10512-1211
Mailing address
180 Gleneida Avenue
Carmel, NY 10512-1211
Phone (845) 225-1038
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 031010-1 | Other | NY | STATE PHARMACY LICENSE |
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)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 031010-1 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1218153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1218153600000",
"number": "1508012642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "180 GLENEIDA AVENUE",
"city": "CARMEL",
"state": "NY",
"postal_code": "105121211",
"telephone_number": "845-225-1038",
"fax_number": "845-228-0257"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "180 GLENEIDA AVENUE",
"city": "CARMEL",
"state": "NY",
"postal_code": "105121211",
"telephone_number": "845-225-1038",
"fax_number": "845-228-0257"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROTHBERG",
"first_name": "MARC",
"middle_name": "MATTHEW",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-08-08",
"last_updated": "2008-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "031010-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE PHARMACY LICENSE",
"identifier": "031010-1",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Carmel, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.