OTTILIE T ROSE (MD) – Pediatrics Physician, NPI 1982626719

OTTILIE T ROSE (MD) is a healthcare provider. based in Derby, Connecticut. specializing in PEDIATRIC MEDICINE, EMERGENCY MEDICINE. They hold the professional credentials MD. They hold a License No. 030635 (CT). The NPI Number for OTTILIE T ROSE (MD) is 1982626719

Main info

Female
41 Years Of Experience
Name
OTTILIE T ROSE (MD)
NPI
1982626719
Phone
(203) 709-8873
Address
78 PERSHING DR
Enumeration Date
24 July 2006
Last Update Date
1 June 2022

Doctor Profile

Medical School Name
NEW YORK MEDICAL COLLEGE
Secondary Phone
2036751345
Graduation Year
1985 (41 years ago)
PAC ID
9133153844
Group Practice PAC ID
0749642726
Professional Enrollment ID
I20050922000259
Address ID
CT065114549NE527XXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

414 PEDIATRIC MEDICINE in CT

Provider Addresses for OTTILIE T ROSE (MD)

  • 78 PERSHING DR

    DERBY, CT 064181433

    Phone: (203) 709-8873

    Fax: (203) 709-8689

    Type: Mailing

  • Saint Mary's Hospital, 56, Franklin Street, Exchange Place, Waterbury, New Haven County, Connecticut, 06706, United States

    3RD FLOOR

    WATERBURY, CT 067061221

    Phone: (203) 709-8873

    Fax: (203) 709-8689

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2005-09-22

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20050922000259IPediatric MedicineCTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
87426Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus7569$0
99213Established patient office or other outpatient visit, 20-29 minutes6660$0
87804Detection test by immunoassay with direct visual observation for influenza virus6230$0
99203New patient office or other outpatient visit, 30-44 minutes4242$0
99214Established patient office or other outpatient visit, 30-39 minutes3128$0
View full utilization report →

Insurance plans in this area (ZIP 06418)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0749642726View full group profile
NameSpecialtyState
Physician AssistantNY
Nurse PractitionerMI
Nurse PractitionerCT
Physician AssistantCT
Physician AssistantNY
Nurse PractitionerCT
Physician AssistantNY
Emergency Medicine, Internal MedicineCT
Physician AssistantCT
Physician AssistantMA

Reviews

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Frequently asked questions

What is OTTILIE T ROSE (MD)'s NPI number?
OTTILIE T ROSE (MD)'s NPI is 1982626719 — the number used across U.S. healthcare to identify this provider.
Would OTTILIE T ROSE (MD) appear as active to a payer?
You can treat OTTILIE T ROSE (MD) as active for directory purposes; confirm clinical privileges separately.
What area of care is associated with OTTILIE T ROSE (MD)?
OTTILIE T ROSE (MD)'s record emphasizes Pediatrics Physician. Clinical services aligned with this taxonomy classification.
What practice footprint exists for OTTILIE T ROSE (MD)?
Travel planning: use Derby, Connecticut as the reference point for OTTILIE T ROSE (MD), then confirm.
Can I trust this NPI listing for OTTILIE T ROSE (MD)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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