Individual provider Active NPI

Rollie Duyao Rosete, MD

  • Internal Medicine Physician
  • Tracy, CA
National Provider Identifier
1801838610
Registry record updated Jun 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A53682 Issued in CA
Practice address
4600 S Tracy Blvd
#107
Tracy, CA 95377
Phone
(209) 836-4920
Fax
(209) 836-4935
NPI assigned
Jun 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A53682 CA Primary

Addresses

Primary practice location

4600 S Tracy Blvd
#107
Tracy, CA 95377

Mailing address

4600 S Tracy Blvd
#107
Tracy, CA 95377
Phone (209) 836-4920

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A53682CAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528070400000",
    "number": "1801838610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 S TRACY BLVD",
            "address_2": "#107",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "95377",
            "telephone_number": "209-836-4920",
            "fax_number": "209-836-4935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 S TRACY BLVD",
            "address_2": "#107",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "95377",
            "telephone_number": "209-836-4920",
            "fax_number": "209-836-4935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSETE",
        "first_name": "ROLLIE",
        "middle_name": "DUYAO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2018-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A53682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tracy, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.