Individual provider Active NPI

Andrew R Rothstein, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Rancho Mirage, CA
National Provider Identifier
1619980455
Registry record updated Feb 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E38020 Issued in CA
Practice address
69730 Highway 111
Suite 101
Rancho Mirage, CA 92270-2869
Phone
(760) 328-4669
Fax
(760) 328-6719
NPI assigned
Aug 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X E38020 CA Primary

Addresses

Primary practice location

69730 Highway 111
Suite 101
Rancho Mirage, CA 92270-2869

Mailing address

69730 Highway 111
Suite 101
Rancho Mirage, CA 92270-2869
Phone (760) 328-4669

Other identifiers 1

IdentifierTypeStateIssuer
000E38020MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120531000597 CA Practitioner - Podiatry 2264475656 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 1989
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

77734 Country Club Dr
Suite A2
Palm Desert, CA 92211-0454
Phone (760) 328-4669

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue27

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E38020CAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Desert Podiatry Group Foot & Ankle Surgery CurrentSince Aug 31, 1991 Accepting new patients
Eisenhower Medical Center Past Accepting new patients
Diagnostic Imaging Services Past Accepting new patients
JFK Memorial Hospital, Inc. Past Accepting new patients

Locations

77734 Country Club Dr
Ste A2
Palm Desert, CA 92211
Phone (760) 328-4669

69730 Highway 111
Ste 101
Rancho Mirage, CA 92270
Phone (760) 328-4669

Organizations & group practices 4

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": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329436800000",
    "number": "1619980455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69730 HIGHWAY 111",
            "address_2": "SUITE 101",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922702869",
            "telephone_number": "760-328-4669",
            "fax_number": "760-328-6719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69730 HIGHWAY 111",
            "address_2": "SUITE 101",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922702869",
            "telephone_number": "760-328-4669",
            "fax_number": "760-328-6719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTHSTEIN",
        "first_name": "ANDREW",
        "middle_name": "R",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2012-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E38020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E38020",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Mirage, CA

Sources for this page

Verify at the official NPI Registry.