Individual provider Active NPI

Rommel Ortiz Bote', M.D.

  • Emergency Medicine Physician
  • Kenosha, WI
National Provider Identifier
1841280948
Registry record updated Dec 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
40935 Issued in WI
Practice address
10400 75TH St
Kenosha, WI 53142-7884
Phone
(262) 948-7000
NPI assigned
Oct 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 40935 WI Primary

Addresses

Primary practice location

10400 75TH St
Kenosha, WI 53142-7884

Mailing address

3801 Spring St
Racine, WI 53405-1667

Other identifiers 2

IdentifierTypeStateIssuer
32552300MedicaidWI
40935OtherWIMD LICENSE

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address rbote46959@direct.aurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, NV2 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

Enrollment IDStateProvider typePAC IDDetails
I20110124001029 WI Practitioner - Emergency Medicine 2264427061
I20260518000911 NV Practitioner - Emergency Medicine 2264427061 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urgent Care Nevada LLCGroup PAC ID 7012137037, 106 clinicians

Practice addresses (Care Compare)

2269 N Green Valley Pkwy
Henderson, NV 89014-5025
Phone (702) 855-0500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
40935WIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Racine Emergency Physicians, S.C. Emergency Medicine Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640649600000",
    "number": "1841280948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 SPRING ST",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534051667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10400 75TH ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531427884",
            "telephone_number": "262-948-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTE'",
        "first_name": "ROMMEL",
        "middle_name": "ORTIZ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-28",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "40935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32552300",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD LICENSE",
            "identifier": "40935",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rbote46959@direct.aurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "10400 75th St",
            "city": "Kenosha",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531427884",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "10400 75th St",
            "city": "Kenosha",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531427884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

Verify at the official NPI Registry.