Edward Earl Rotan Jr., M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

A91946 Issued in CA

Practice address

715 N Fielder Rd
Arlington, TX 76012-4695

Phone

(817) 261-1626

Fax

(817) 275-0441

NPI assigned

Jan 12, 2007

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

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA, TX2 enrollments

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 2

Specialty

Family Practice

Education

Loma Linda University School of Medicine, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Primary Health Physicians PLLCGroup PAC ID 7810237740, 240 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Primary Health Physicians, PLLC

  • Urgent Care Clinic/Center
  • Denton, TX
  • NPI 1770048704
  Medicare reassignment Care Compare group NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299

  Dermatology

  Medicare reassignment NPD
• Horizon Medical Associates, P.L.L.C.

  • Family Medicine Physician
  • Arlington, TX
  • NPI 1497025621

  Dermatology

  NPD (past) Authorized official
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Redwood City, CA
  • NPI 1639252604

  Dermatology

  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD
• Paul Phillips III, M.D., P.a.

  dba Phillips Orthopedic Associates

  • Orthopaedic Surgery Physician
  • Fredericksburg, TX
  • NPI 1477045151
  NPD (past)
• Reclaim Physicians Medical Group Inc

  • Family Medicine Physician
  • Grapevine, TX
  • NPI 1811418023
  NPD (past)
• J. Robert West, M.D., Inc

  dba West Dermatology

  • Dermatology Physician
  • Phoenix, AZ
  • NPI 1114567997
  NPD (past)
• Robert West MD Inc

  • Family Medicine Physician
  • Upland, CA
  • NPI 1508920489
  NPD (past)
• West Dermatology of Northern California, Inc

  • Procedural Dermatology Physician
  • Modesto, CA
  • NPI 1568523793
  NPD (past)

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1780734582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19772 MACARTHUR BLVD",
            "address_2": "SUITE 210",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926122413",
            "telephone_number": "949-975-0620",
            "fax_number": "949-975-0628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 N FIELDER RD",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760124695",
            "telephone_number": "817-261-1626",
            "fax_number": "817-275-0441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTAN",
        "first_name": "EDWARD",
        "middle_name": "EARL",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2022-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A91946",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A91946",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL PTAN  NO. CA.",
            "identifier": "00A919461",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00375737",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "3900 Lakeview Highway",
            "city": "Petaluma",
            "state": "CA",
            "country_code": "US",
            "postal_code": "94954",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Janie Ross, PTA
• Lillian Thornton Ross, DPT
• Michael Ross, M.D.
• Nicholas Quenton Ross
• Laura Rosser, LPC
• Colton Thomas Rouse
• Cassandra Hayes Rowe, LPC-S
• Kristin Rowe
• Asia Roy
• Royal Medical Supplies

• Dermatology Physician in Arlington, TX
• Providers in Arlington, TX by specialty
• Dermatology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.