Individual provider Active NPI

Jay Allen Rothman, M.D.

  • General Acute Care Hospital
  • Huntington Beach, CA
National Provider Identifier
1922110402
Registry record updated Jan 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
G18582 Issued in CA
Practice address
17822 Beach Blvd Ste 373
Huntington Beach, CA 92647-7115
Phone
(714) 848-0023
Fax
(714) 848-6782
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X G18582 CA Primary

Addresses

Primary practice location

17822 Beach Blvd Ste 373
Huntington Beach, CA 92647-7115

Mailing address

17822 Beach Blvd Ste 373
Huntington Beach, CA 92647-7115
Phone (714) 848-0023

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G18582CAMDGeneral Acute Care Hospital

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327017600000",
    "number": "1922110402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17822 BEACH BLVD STE 373",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926477115",
            "telephone_number": "714-848-0023",
            "fax_number": "714-848-6782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17822 BEACH BLVD STE 373",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926477115",
            "telephone_number": "714-848-0023",
            "fax_number": "714-848-6782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTHMAN",
        "first_name": "JAY",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2012-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "CA",
            "license": "G18582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2012; 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.