Organization Active NPI

Judy Rotondi LLC

  • Clinical Social Worker
  • Bend, OR
National Provider Identifier
1942441324
Registry record updated Mar 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L2636 Issued in OR
Legal business name
JUDY ROTONDI LLC
Practice address
754 NW Broadway St
Suite 201
Bend, OR 97701-2776
Phone
(541) 280-2789
Fax
(541) 383-7121
NPI assigned
Mar 16, 2009
Last updated
Mar 16, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2009

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

Authorized official

Name
Ms. Judy Lea Rotondi, LCSWNPI 1619988706
Title
Social Worker
Phone
(541) 280-2789

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X L2636 OR Primary

Addresses

Primary practice location

754 NW Broadway St
Suite 201
Bend, OR 97701-2776

Mailing address

754 NW Broadway St
Suite 201
Bend, OR 97701-2776
Phone (541) 280-2789

Other identifiers 1

IdentifierTypeStateIssuer
1619988706OtherORNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090407000268 OR Part B Supplier - Clinic/Group Practice 6103973219 Receives reassigned benefits from 1 practitioner
Practice locations: Bend, OR

National Provider Directory

National Provider Directory

Locations

2052 NE 4th St
Bend, OR 97701
Phone (541) 280-2789

754 NW Broadway St
Ste 201
Bend, OR 97703
Phone (541) 280-2789

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1237161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237161600000",
    "number": "1942441324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "754 NW BROADWAY ST",
            "address_2": "SUITE 201",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977012776",
            "telephone_number": "541-280-2789",
            "fax_number": "541-383-7121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "754 NW BROADWAY ST",
            "address_2": "SUITE 201",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977012776",
            "telephone_number": "541-280-2789",
            "fax_number": "541-383-7121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUDY ROTONDI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-16",
        "last_updated": "2009-03-16",
        "status": "A",
        "authorized_official_last_name": "ROTONDI",
        "authorized_official_first_name": "JUDY",
        "authorized_official_middle_name": "LEA",
        "authorized_official_title_or_position": "SOCIAL WORKER",
        "authorized_official_telephone_number": "541-280-2789",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L2636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1619988706",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.