Active NPI
Robert Hottentot, D.O.
- Orthopaedic Surgery Physician
- Bangor, MA
National Provider Identifier
1992801286
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 1027
- Practice address
- 489 State Street
Bangor, MA 04401 - Phone
- (207) 973-7000
- NPI assigned
- Sep 15, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 1027 | ME | Primary |
Addresses
Primary practice location
489 State Street
Bangor, MA 04401
Mailing address
349 Snow Pond Road
Oakland, MA 04963
Phone (207) 465-3683
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)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1027 | ME | MD | Orthopaedic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1992801286",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "349 SNOW POND ROAD",
"city": "OAKLAND",
"state": "MA",
"postal_code": "04963",
"telephone_number": "207-465-3683",
"fax_number": "207-465-3429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "489 STATE STREET",
"city": "BANGOR",
"state": "MA",
"postal_code": "04401",
"telephone_number": "207-973-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOTTENTOT",
"first_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "ME",
"license": "1027",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bangor, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.