Individual provider Active NPI

John Rossettie, M.D.

  • Internal Medicine Physician
  • San Diego, CA
National Provider Identifier
1578908372
Registry record updated Dec 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A134486 Issued in CA
Practice address
200 W Arbor Dr # 8422
San Diego, CA 92103-1911
Phone
(619) 543-6268
Fax
(619) 543-6529
NPI assigned
May 7, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A134486 CA Primary

Addresses

Primary practice location

200 W Arbor Dr # 8422
San Diego, CA 92103-1911

Mailing address

200 W Arbor Dr # 8422
San Diego, CA 92103-1911
Phone (619) 543-6268

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A134486CAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1367884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481673600000",
    "number": "1578908372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR # 8422",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921031911",
            "telephone_number": "619-543-6268",
            "fax_number": "619-543-6529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR # 8422",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921031911",
            "telephone_number": "619-543-6268",
            "fax_number": "619-543-6529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSSETTIE",
        "first_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-07",
        "last_updated": "2016-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A134486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2016; 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.