Individual provider Active NPI

Judy L Rotondi, LCSW

  • Clinical Social Worker
  • Bend, OR
National Provider Identifier
1619988706
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L2636 Issued in OR
Practice address
2542 NE Courtney Dr
Bend, OR 97701-7685
Phone
(541) 322-2768
Fax
(541) 322-4760
NPI assigned
Aug 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X L2636 OR Primary

Addresses

Primary practice location

2542 NE Courtney Dr
Bend, OR 97701-7685

Mailing address

2542 NE Courtney Dr
Bend, OR 97701-7685
Phone (541) 322-2768

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071003000433 OR Practitioner - Clinical Social Worker 5991890105 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2052 NE 4TH St
Bend, OR 97701-3825
Phone (541) 280-2789

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Judy Rotondi LLC Clinical CurrentSince Apr 1, 2009 Accepting new patients
Resolutions Creative Conflict Management, Inc Clinical PastSince Dec 1, 2008 Accepting new patients

Locations

2052 NE 4th St
Bend, OR 97701
Phone (541) 280-2789

Organizations & group practices 2

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": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619988706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2542 NE COURTNEY DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977017685",
            "telephone_number": "541-322-2768",
            "fax_number": "541-322-4760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2542 NE COURTNEY DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977017685",
            "telephone_number": "541-322-2768",
            "fax_number": "541-322-4760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTONDI",
        "first_name": "JUDY",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L2636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.