Robert M Dotterrer, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

4301050243 Issued in MI

Practice address

6609 Peninsula Dr
Traverse City, MI 49686-1737

Phone

(231) 935-2191

NPI assigned

Aug 2, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Robert M Dotterrer MD

  • Surgery Physician
  • Traverse City, MI
  • NPI 1083667059
  NPD (past) Authorized official
• Elk Rapids Medical Clinic, P.C.

  • Family Medicine Physician
  • Elk Rapids, MI
  • NPI 1639351984
  NPD (past)
• John M Cilluffo MD PLC

  • Neurological Surgery Physician
  • Petoskey, MI
  • NPI 1740519818
  NPD (past)
• Northwest Michigan Surgical Group, P.C.

  • Surgery Physician
  • Traverse City, MI
  • NPI 1386659043
  NPD (past)

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548374400000",
    "number": "1962403717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6609 PENINSULA DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496861737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6609 PENINSULA DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496861737",
            "telephone_number": "231-935-2191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOTTERRER",
        "first_name": "ROBERT",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2019-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301050243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "0202810041",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1930282",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MUNSON MEDICARE PIN",
            "identifier": "B86018144",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET/TRICARE",
            "identifier": "382991220",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0202810041",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIORITY",
            "identifier": "B46660",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ROBERT M DOTTERRER MD",
            "identifier": "1962403717",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diane K. Donley, M.D.
• Allee J Donnelly, BEHAVIOR TECHNICIAN
• Kelly R Donovan, DO
• Andrew Doorn, PA-C
• Daniel James Dorrance
• Carrie Douglas
• Mary Kathryn Douglas, PAC
• Bruce G Douglass, PHD
• Katharine C Douglass, M.S.
• Nancy Dow

• Surgery Physician in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2019; 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.