| 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 | 41 Years |
| Location | 78 Pershing Dr, Derby, Connecticut |
| Accepts Medicare Assignments | May be. She may accept the Medicare-approved amount; you may be billed for 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 | 10 |
| Qmg3 Llc | 8628353117 | 13 |
| 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 | 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 |