Individual provider Active NPI

Rochel Dombroff, PAC

  • Physician Assistant
  • Glen Burnie, MD
National Provider Identifier
1831281757
Registry record updated May 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0003016 Issued in MD
Practice address
301 Hospital Dr
Glen Burnie, MD 21061-5803
Phone
(410) 787-4565
Fax
(410) 766-7602
NPI assigned
Sep 28, 2006
Last updated
May 3, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0003016 MD Primary

Addresses

Primary practice location

301 Hospital Dr
Glen Burnie, MD 21061-5803

Mailing address

PO Box 8160
Philadelphia, PA 19101-8160
Phone (800) 355-3818

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100126000524 NJ Practitioner - Physician Assistant 5799731121 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

108 Hillside Blvd
Lakewood, NJ 08701-3148
Phone (732) 364-2144

1771 Madison Ave
Lakewood, NJ 08701-1242
Phone (732) 364-2144

1771 Madison Ave
Lakewood, NJ 08701-1251

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lakewood Resource and Referral Center Inc CurrentSince Dec 16, 2015 Accepting new patients
Lakewood Resource and Referral Center, Inc. CurrentSince Dec 16, 2015 Accepting new patients
Friendly Urgent Care, LLC CurrentSince Apr 8, 2019 Accepting new patients

Locations

108 Hillside Blvd
Lakewood, NJ 08701
Phone 73236421445370

1771 Madison Ave
Lakewood, NJ 08701
Phone (732) 364-2144

1428 Teaneck Rd
Teaneck, NJ 07666
Phone (201) 591-1350

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304380800000",
    "number": "1831281757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8160",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191018160",
            "telephone_number": "800-355-3818",
            "fax_number": "610-834-2862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 HOSPITAL DR",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615803",
            "telephone_number": "410-787-4565",
            "fax_number": "410-766-7602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMBROFF",
        "first_name": "ROCHEL",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2011-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0003016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

Verify at the official NPI Registry.