Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

JACOB ROTTER MD
NPI 1720547821
Pediatrics in Babylon, NY

Q: What is Jacob Rotter's NPI number?

The NPI number for Jacob Rotter is 1720547821. It was assigned to this individual provider in the NPPES registry on March 18, 2019.

Q: What is Jacob Rotter's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Jacob Rotter was last updated on October 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 18, 2019PECOS Enrolled

655 DEER PARK AVE, BABYLON, NY 11702(631) 321-2100 Get Directions Write a Review

NPPES record last updated: October 5, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 5, 2026, May 6, 2022, Mar 18, 2019 (3 updates tracked since 2019).

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About Jacob Rotter Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACOB ROTTER MD (NPI 1720547821) is an individual pediatrics provider in Babylon, New York, licensed in New York (315541-01) and active in the NPI registry since March 2019. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1720547821

Entity TypeIndividualMale

Primary Taxonomy208000000X

Provider Legal NameJACOB ROTTERCredential: MD

Location Address655 DEER PARK AVEBabylon, NY 11702-1314

Mailing Address655 Deer Park AveBabylon, NY 11702-1314

Phone(631) 321-2100

Sole ProprietorNo

Enumeration DateMarch 18, 2019

Last NPPES UpdateOctober 5, 20263 updates tracked since enumeration

NPPES CertifiedOctober 5, 2026

✔ NPI 1720547821 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in NY · 315541-01

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Also ListedPediatrics · Pediatric GastroenterologyTaxonomy 2080P0206X · License 315541-01 (NY)

655 DEER PARK AVE, Babylon, NY 11702

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jacob Rotter Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Jacob Rotter reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

North Shore - Lij Medical PC

21 mi

Internal Medicine

270-05 76TH AVE
New Hyde Park, NY 11040

Reassigned Medicare billing, New York enrollment
9,353 clinicians in this Medicare group

NPI 1790043479 (516) 465-8089

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11702 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$105.06 typical visit price

range $67.40 – $203.53

Typical copayment $26.26 (range $16.85 – $50.88)

Most-billed visit code 99203

Established Patient

$117.62 typical visit price

range $21.66 – $164.45

Typical copayment $29.40 (range $5.41 – $41.11)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 19

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. CATHERINE ANNE WIELAND NP

Nurse Practitioner (Pediatrics)