Organization Active NPI

Eric S Rothenberg MD PA

  • Specialist
  • Pasadena, TX
National Provider Identifier
1659674604
Registry record updated Jun 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
J1029 Issued in TX
Legal business name
ERIC S ROTHENBERG MD PA
Practice address
4500 E Sam Houston Pkwy S
Suite 102
Pasadena, TX 77505-3959
Phone
(281) 998-9000
Fax
(281) 998-8001
NPI assigned
Dec 14, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2012

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

Authorized official

Name
Kathy A Payne
Title
Office Manager
Phone
(281) 998-9000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X J1029 TX Primary

Addresses

Primary practice location

4500 E Sam Houston Pkwy S
Suite 102
Pasadena, TX 77505-3959

Mailing address

4500 E Sam Houston Pkwy S
Suite 102
Pasadena, TX 77505-3959
Phone (281) 998-9000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110505000128 TX Part B Supplier - Clinic/Group Practice 6002913092 Receives reassigned benefits from 1 practitioner
Practice locations: Pasadena, TX

National Provider Directory

National Provider Directory
Tax ID family
Eric S Rothenberg MD PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5150 Crenshaw Rd
Ste G120
Pasadena, TX 77505
Phone (281) 998-9000

4500 E Sam Houston Pkwy S
Ste 102
Pasadena, TX 77505
Phone (281) 998-0172

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1292284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340841600000",
    "number": "1659674604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 E SAM HOUSTON PKWY S",
            "address_2": "SUITE 102",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775053959",
            "telephone_number": "281-998-9000",
            "fax_number": "281-998-8001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 E SAM HOUSTON PKWY S",
            "address_2": "SUITE 102",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775053959",
            "telephone_number": "281-998-9000",
            "fax_number": "281-998-8001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERIC S ROTHENBERG MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-14",
        "last_updated": "2012-06-28",
        "status": "A",
        "authorized_official_last_name": "PAYNE",
        "authorized_official_first_name": "KATHY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "281-998-9000"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": "J1029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.