Active NPI
Emanuel James Rothis, D.D.S
- General Practice Dentistry
- Eastpointe, MI
National Provider Identifier
1720179823
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2901007533
- Practice address
- 22770 Kelly Rd
Eastpointe, MI 48021-2009 - Phone
- (586) 775-0520
- Fax
- (586) 775-2670
- NPI assigned
- Sep 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2901007533 | MI | Primary |
Addresses
Primary practice location
22770 Kelly Rd
Eastpointe, MI 48021-2009
Mailing address
22770 Kelly Rd
Eastpointe, MI 48021-2009
Phone (586) 775-0520
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 053109 | Other | MI | FIRST COMMONWEALTH ID # |
| 4012430 | Medicaid | MI | |
| 0002091 | Other | MI | FORTIS ID NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Paul E Marcuz D.D.S.,P.C. | General Practice | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Eastpointe, MI
- NPI 1073790200
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1720179823",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22770 KELLY RD",
"city": "EASTPOINTE",
"state": "MI",
"postal_code": "480212009",
"telephone_number": "586-775-0520",
"fax_number": "586-775-2670"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22770 KELLY RD",
"city": "EASTPOINTE",
"state": "MI",
"postal_code": "480212009",
"telephone_number": "586-775-0520",
"fax_number": "586-775-2670"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROTHIS",
"first_name": "EMANUEL",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "D.D.S",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-27",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MI",
"license": "2901007533",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST COMMONWEALTH ID #",
"identifier": "053109",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4012430",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FORTIS ID NUMBER",
"identifier": "0002091",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Eastpointe, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.