Individual provider Active NPI

David R Rogerson, MD

  • Otolaryngic Allergy Physician
  • Johnstown, PA
National Provider Identifier
1902816630
Registry record updated Dec 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngic Allergy PhysicianTaxonomy code 207YX0602X
License
MD016845E Issued in PA
Practice address
348 Budfield Street
Johnstown, PA 15904-3214
Phone
(814) 262-3950
Fax
(814) 262-3990
NPI assigned
Aug 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngic Allergy Physician 207YX0602X MD016845E PA Primary

Addresses

Primary practice location

348 Budfield Street
Johnstown, PA 15904-3214

Mailing address

348 Budfield Street
Johnstown, PA 15904-3214
Phone (814) 262-3950

Other identifiers 1

IdentifierTypeStateIssuer
0007090960003MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20100128000283 PA Practitioner - OtolaryngologyPractitioner - Allergy/Immunology 9032183637

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Icare Medical CurrentSince Jun 15, 2017 Accepting new patients
Ear Nose and Throat Associates of Johnstown, Inc. Otolaryngic Allergy Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

100 Susan Dr
Johnstown, PA 15905
Phone (814) 255-1963

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": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259625600000",
    "number": "1902816630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "348 BUDFIELD STREET",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159043214",
            "telephone_number": "814-262-3950",
            "fax_number": "814-262-3990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "348 BUDFIELD STREET",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159043214",
            "telephone_number": "814-262-3950",
            "fax_number": "814-262-3990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERSON",
        "first_name": "DAVID",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2009-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0602X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": "PA",
            "license": "MD016845E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0007090960003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnstown, PA

Sources for this page

Verify at the official NPI Registry.