Individual provider Active NPI

Dwayne Eric Rollins, MD

  • Otolaryngology Physician
  • Rosedale, NY
National Provider Identifier
1861447153
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
222755 Issued in NY
Practice address
25302 147TH Ave
Rosedale, NY 11422-2541
Phone
(718) 978-5447
Fax
(718) 978-8752
NPI assigned
May 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 222755 NY Primary

Addresses

Primary practice location

25302 147TH Ave
Rosedale, NY 11422-2541

Mailing address

25302 147TH Ave
Rosedale, NY 11422-2541
Phone (718) 978-5447

Other identifiers 1

IdentifierTypeStateIssuer
02413427MedicaidNY

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040504001549 NY Practitioner - Otolaryngology 6103814439 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Howard University College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

25302 147TH Ave
Rosedale, NY 11422-2541
Phone (718) 978-5447

Merit-based Incentive Payment System (MIPS)

Final score
75.04 of 100Reported as individual
Quality
50.08
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dwayne E. Rollins, MD, PC Otolaryngology CurrentSince Feb 3, 2006 Accepting new patients
ENT and Allergy Associates LLP Otolaryngology PastSince Jul 1, 2022 Accepting new patients
Ear, Nose & Throat Associates of New York,P.C. Otolaryngology PastSince Feb 1, 1990 Accepting new patients

Locations

25302 147th Ave
Rosedale, NY 11422
Phone (718) 341-3535

18718 Linden Blvd
Saint Albans, NY 11412
Phone (347) 894-8111

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CJHFBA
  • FHIR API: https://fhir4.healow.com/fhir/r4/CJHFBA/Endpoint/CJHFBA
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1861447153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25302 147TH AVE",
            "city": "ROSEDALE",
            "state": "NY",
            "postal_code": "114222541",
            "telephone_number": "718-978-5447",
            "fax_number": "718-978-8752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25302 147TH AVE",
            "city": "ROSEDALE",
            "state": "NY",
            "postal_code": "114222541",
            "telephone_number": "718-978-5447",
            "fax_number": "718-978-8752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLLINS",
        "first_name": "DWAYNE",
        "middle_name": "ERIC",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NY",
            "license": "222755",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02413427",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rosedale, NY

Sources for this page

Verify at the official NPI Registry.