Individual provider Active NPI

Jason Tyler Rothchild, MD

  • Family Medicine Physician
  • Munster, IN
National Provider Identifier
1972122455
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01088579A Issued in IN
Practice address
10240 Calumet Ave FL 2
Munster, IN 46321-4082
Phone
(197) 038-2992
Fax
(219) 703-6517
NPI assigned
Apr 14, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01088579A IN Primary

Addresses

Primary practice location

10240 Calumet Ave FL 2
Munster, IN 46321-4082

Mailing address

8558 Broadway
Merrillville, IN 46410-7032
Phone (219) 392-7084

Other identifiers 2

IdentifierTypeStateIssuer
300072641MedicaidIN
1102860751OtherINANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20230719003803 IN Practitioner - Family Practice 2264855923 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Indiana University School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Care Network IncGroup PAC ID 3678737012, 378 clinicians

Practice addresses (Care Compare)

921 Fran Lin Pkwy
Munster, IN 46321-3540
Phone (219) 836-1310

Hospital & facility affiliations

  • Powers Home Health Services Home health agency, Hobart, IN, CCN 157313
  • Community Hospital Hospital, Munster, IN, CCN 150125
  • St Catherine Hospital Inc Hospital, East Chicago, IN, CCN 150008
  • Powers Health Rehabilitation Center Inpatient rehabilitation facility, Crown Point, IN, CCN 153045

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01088579AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Network Inc Family Medicine CurrentSince Jul 24, 2023 Accepting new patients

Locations

8558 Broadway
Merrillville, IN 46410
Phone (219) 392-7084

921 Fran Lin Pkwy
Munster, IN 46321
Phone (219) 836-0488

9130 Columbia Ave
Ste A
Munster, IN 46321
Phone (219) 365-1166

10240 Calumet Ave
Munster, IN 46321
Phone (219) 440-5286

10240 Calumet Ave
Fl 2
Munster, IN 46321
Phone (219) 836-8100

Interoperability endpoints

  • Direct secure messaging: jrothchild84642@ssdirect.comhs.org

Organizations & group practices 1

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1586822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1972122455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8558 BROADWAY",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464107032",
            "telephone_number": "219-392-7084",
            "fax_number": "219-703-6854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10240 CALUMET AVE FL 2",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463214082",
            "telephone_number": "197-038-2992",
            "fax_number": "219-703-6517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTHCHILD",
        "first_name": "JASON",
        "middle_name": "TYLER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-14",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01088579A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300072641",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "1102860751",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Munster, IN

Sources for this page

Verify at the official NPI Registry.