Ottilie T Rose, MD | |
78 Pershing Dr, Derby, CT 06418-1433 | |
(203) 709-8873 | |
(203) 709-8689 |
Full Name | Ottilie T Rose |
---|---|
Gender | Female |
Speciality | Pediatric Medicine |
Experience | 39 Years |
Location | 78 Pershing Dr, Derby, Connecticut |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1982626719 | NPI | - | NPPES |
001306358 | Medicaid | CT |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 030635 (Connecticut) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Qmg7 Llc | 0749642726 | 7 |
Qmg5 Llc | 2062820913 | 13 |
Qmg4 Llc | 4284912957 | 14 |
Qmg3 Llc | 8628353117 | 12 |
Entity Name | Quentin Medical Group Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1487087250 PECOS PAC ID: 4981833647 Enrollment ID: O20140130000098 |
Entity Name | Qmg 2 Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1437546363 PECOS PAC ID: 0345541512 Enrollment ID: O20151211000754 |
Entity Name | Qmg4 Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1023471299 PECOS PAC ID: 4284912957 Enrollment ID: O20161031002469 |
Entity Name | Qmg3 Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1053856039 PECOS PAC ID: 8628353117 Enrollment ID: O20170324000321 |
Entity Name | Medexpress Urgent Care Connecticut, P.c. |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1528592417 PECOS PAC ID: 0749552388 Enrollment ID: O20170920002629 |
Entity Name | Qmg5 Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1386233344 PECOS PAC ID: 2062820913 Enrollment ID: O20210414002118 |
Entity Name | Qmg7 Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1487367199 PECOS PAC ID: 0749642726 Enrollment ID: O20230809000584 |
Mailing Address | Practice Location Address |
---|---|
Ottilie T Rose, MD 78 Pershing Dr, Derby, CT 06418-1433 Ph: (203) 709-8873 | Ottilie T Rose, MD 78 Pershing Dr, Derby, CT 06418-1433 Ph: (203) 709-8873 |
Mr. Joseph Berlenbach, P.A. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 130 Division St, Derby, CT 06418 Phone: 203-732-1330 Fax: 203-732-1332 | |
Dr. Robert Nelson Hyde Iii, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 111 New Haven Ave, Derby, CT 06418 Phone: 203-736-9214 Fax: 203-736-9172 |