DR. MICHAEL THOMAS ROTHERMICH (M.D.) – Family Medicine Physician, NPI 1629063524

DR. MICHAEL THOMAS ROTHERMICH (M.D.) is a healthcare provider. based in Montgomery city, Missouri. specializing in FAMILY PRACTICE. They hold the professional credentials M.D.. They hold a License No. 2002011778 (MO). The NPI Number for DR. MICHAEL THOMAS ROTHERMICH (M.D.) is 1629063524

Main info

Male
26 Years Of Experience
Accepts Medicare Assignment
Name
DR. MICHAEL THOMAS ROTHERMICH (M.D.)
NPI
1629063524
Phone
(573) 564-2990
Address
504 N STURGEON ST
Enumeration Date
16 September 2005
Last Update Date
8 February 2012

Doctor Profile

Medical School Name
UNIVERSITY OF MISSOURI, COLUMBIA SCHOOL OF MEDICINE
Secondary Phone
-
Graduation Year
2000 (26 years ago)
PAC ID
0547366023
Group Practice PAC ID
5496669962
Professional Enrollment ID
I20070430000150
Address ID
MO650411547HE509XXBOXX601
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

2,330 FAMILY PRACTICE in MO

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Provider Addresses for DR. MICHAEL THOMAS ROTHERMICH (M.D.)

  • 504, North Sturgeon Street, Montgomery City, Montgomery County, Missouri, 63361, United States

    MONTGOMERY CITY, MO 633611829

    Phone: (573) 564-2990

    Type: Location

  • Hermann, Gasconade County, Missouri, United States

    HERMANN, MO 650410019

    Phone: (573) 486-1193

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $25.

Total Amount is formed as General ($25) + Research ($0) + Ownership ($0) = $25.

Last reported payment date: 2023-11-06 • Largest payer in this snapshot: Dexcom, Inc. ($25).

Total Amount

$25

General + Research + Ownership

Payments

1

Total payment records

General Amount

$25

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-11-06

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Dexcom, Inc.$25
View all Open Payments →|Open Payments Risk Radar →

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: 2007-04-30

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
I20070430000150IFamily PracticeMOTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 63361)

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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: 5496669962View full group profile
NameSpecialtyState
Hospitalist, Family PracticeMO
Hospitalist, Internal MedicineWI
-MO
H O S P I T A L I S TMO
Clinical Social WorkerMO
Mental Health CounselorMO
Nurse PractitionerMO
Clinical Social WorkerMO
General SurgeryMO
Nurse PractitionerMO

Reviews

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Frequently asked questions

How do payers reference DR. MICHAEL THOMAS ROTHERMICH (M.D.)?
For DR. MICHAEL THOMAS ROTHERMICH (M.D.), use NPI 1629063524 as the unique 10-digit identifier.
Is DR. MICHAEL THOMAS ROTHERMICH (M.D.) shown as active in public data?
Registry records indicate DR. MICHAEL THOMAS ROTHERMICH (M.D.) maintains an active NPI.
How would a patient describe DR. MICHAEL THOMAS ROTHERMICH (M.D.)'s focus?
For DR. MICHAEL THOMAS ROTHERMICH (M.D.), the primary taxonomy reads as Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What practice footprint exists for DR. MICHAEL THOMAS ROTHERMICH (M.D.)?
Travel planning: use Montgomery City, Missouri as the reference point for DR. MICHAEL THOMAS ROTHERMICH (M.D.), then confirm.
Can I trust this NPI listing for DR. MICHAEL THOMAS ROTHERMICH (M.D.)?
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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