Edmund J Rotty, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12974 Issued in MA

Practice address

914 Main Street
Southbridge, MA 01550

Phone

(508) 765-5985

NPI assigned

Jan 8, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Anthony G. Dimatteo DDS

  • General Practice Dentistry
  • Southbridge, MA
  • NPI 1306994702
  NPD (past)

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700934106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "914 MAIN STREET",
            "city": "SOUTHBRIDGE",
            "state": "MA",
            "postal_code": "01550",
            "telephone_number": "508-765-5985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "914 MAIN STREET",
            "city": "SOUTHBRIDGE",
            "state": "MA",
            "postal_code": "01550",
            "telephone_number": "508-765-5985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTTY",
        "first_name": "EDMUND",
        "middle_name": "J",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "12974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "X10388DR",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0246409",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL",
            "identifier": "000112",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erica M. Rosario
• Warren William Rose, M.D.
• Jonathan Michael Rosen, LICSW
• Joyce S Rosenfeld, M.D.
• Melanie Rossi
• Rahul Dev Roy
• Abhijit Roychowdhury, MD
• Denis A Rozo
• Allen Jay Rubin, DMD
• Stephanie Ruiz-Gonzalez, CRNA

• General Practice Dentistry in Southbridge, MA
• Providers in Southbridge, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.