Jacob Rotter, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

315541-01 Issued in NY

Practice address

655 Deer Park Ave
Babylon, NY 11702-1314

Phone

(631) 321-2100

NPI assigned

Mar 18, 2019

Last updated

Oct 5, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• North Shore-Lij Medical PC

  dba NHPP Cardiology at Great Neck

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572
  Medicare reassignment NPD
• North Shore - Lij Medical PC

  dba NSLIJ Medical In Queens

  • Internal Medicine Physician
  • New Hyde Park, NY
  • NPI 1790043479
  NPD

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

{
    "created_epoch": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791158400000",
    "number": "1720547821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 DEER PARK AVE",
            "city": "BABYLON",
            "state": "NY",
            "postal_code": "117021314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 DEER PARK AVE",
            "city": "BABYLON",
            "state": "NY",
            "postal_code": "117021314",
            "telephone_number": "631-321-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTTER",
        "first_name": "JACOB",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-18",
        "last_updated": "2026-10-05",
        "certification_date": "2026-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "315541-01",
            "primary": true
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "NY",
            "license": "315541-01",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Seth Elliot Roman, LMSW
• Jennifer Jean Romano, M.S., CCC-SLP
• Marion B Rose, M.D.
• Jaclyn Rosen, MS, CNS, CDN
• Jenna Elise Rosenberg
• Theresa Maria Rua, O.D.
• Alexandra M Rulli, LCSW
• Courtney Runkel
• Sarah Ruplin
• Ryan M. Cahill D.O. PC

• Pediatrics Physician in Babylon, NY
• Providers in Babylon, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2026; 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.