Individual provider Active NPI

Rodney A Rozario, MD

  • Specialist
  • Bangor, ME
National Provider Identifier
1619965076
Registry record updated Feb 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
010634 Issued in ME
Practice address
417 State St
Suite 221
Bangor, ME 04401-6630
Phone
(207) 973-9949
Fax
(207) 973-9555
NPI assigned
Oct 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 010634 ME Primary

Addresses

Primary practice location

417 State St
Suite 221
Bangor, ME 04401-6630

Mailing address

43 Whiting Hill Rd Ste 300
Brewer, ME 04412-1006
Phone (207) 973-5035

Other identifiers 2

IdentifierTypeStateIssuer
043005OtherMEANTHEM BCBS
280540099MedicaidME

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
010634MEMDSpecialist
10634NEMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392768000000",
    "number": "1619965076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 WHITING HILL RD STE 300",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "044121006",
            "telephone_number": "207-973-5035",
            "fax_number": "207-973-5042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 STATE ST",
            "address_2": "SUITE 221",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016630",
            "telephone_number": "207-973-9949",
            "fax_number": "207-973-9555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROZARIO",
        "first_name": "RODNEY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-10",
        "last_updated": "2014-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "ME",
            "license": "010634",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "043005",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "280540099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2014; 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.