NPIMap

Individual provider Active NPI

Jonathan D. Rothberg, M.D.

  • Internal Medicine Physician
  • Medford, MA
National Provider Identifier
1972582682
Registry record updated Feb 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
207435 Issued in MA
Practice address
101 Main St Ste 116
Medford, MA 02155-4530
Phone
(781) 396-2000
Fax
(781) 395-0759
NPI assigned
Jan 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 207435 MA Primary

Addresses

Primary practice location

101 Main St Ste 116
Medford, MA 02155-4530

Mailing address

101 Main St Ste 116
Medford, MA 02155-4530
Phone (781) 396-2000

Other identifiers 1

IdentifierTypeStateIssuer
2035979MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040428000018 MA Practitioner - Internal Medicine 2264429620 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Loyola University of Chicago, Stritch School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hallmark Health Medical Associates IncGroup PAC ID 4385638782, 151 clinicians

Practice addresses (Care Compare)

101 Main St
Medford, MA 02155-4530
Phone (781) 396-2000

Hospital & facility affiliations

  • All Care Vna-Greater Lynn Inc Home health agency, Lynn, MA, CCN 227263
  • Pathways Healthcare Home health agency, Westwood, MA, CCN 227569
  • Tufts Medicine Care at Home Home health agency, Lowell, MA, CCN 227206
  • Mass General Brigham Home Care, Inc Home health agency, Newton, MA, CCN 227207
  • Bayada Home Health Care, Inc Home health agency, Wilmington, MA, CCN 227576
  • Melrosewakefield Healthcare Hospital, Melrose, MA, CCN 220070
  • Tufts Medical Center Hospital, Boston, MA, CCN 220116
  • Boston Medical Center Hospital, Boston, MA, CCN 220031
  • Winchester Hospital Hospital, Winchester, MA, CCN 220105

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
207435MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hallmark Health Medical Associates Inc Internal Medicine CurrentSince Jan 1, 2020 Accepting new patients

Locations

101 Main St
Ste 116
Medford, MA 02155
Phone (781) 391-2121

425 Revere St
Revere, MA 02151
Phone (781) 286-1313

Interoperability endpoints

  • Direct secure messaging: jrothberg28894@tuftsmedicine.direct-ci.com
  • Direct secure messaging: jrothberg188687@direct.ochin.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 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613692800000",
    "number": "1972582682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 MAIN ST STE 116",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021554530",
            "telephone_number": "781-396-2000",
            "fax_number": "781-395-0759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MAIN ST STE 116",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021554530",
            "telephone_number": "781-396-2000",
            "fax_number": "781-395-0759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTHBERG",
        "first_name": "JONATHAN",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-11",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "207435",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2035979",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, MA

Sources for this page

Verify at the official NPI Registry.