Provider Demographics
NPI:1306813142
Name:ROGGE, SCOTT W (MD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:W
Last Name:ROGGE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 946
Mailing Address - Street 2:
Mailing Address - City:BENNINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05201-0946
Mailing Address - Country:US
Mailing Address - Phone:802-442-0800
Mailing Address - Fax:802-442-0212
Practice Address - Street 1:140 HOSPITAL DRIVE
Practice Address - Street 2:SUITE 312
Practice Address - City:BENNINGTON
Practice Address - State:VT
Practice Address - Zip Code:05201
Practice Address - Country:US
Practice Address - Phone:802-442-0800
Practice Address - Fax:802-442-0212
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0420008933207RC0000X
NY1862781207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
5731230OtherAETNA
00019771OtherBLUE CARE
Z56144OtherBCBS OF MA
00019771OtherBCBS OF VT
NY01736052Medicaid
030349278OtherAMERICAN PROGRESSIVE
030349278OtherBANKERS LIFE
030349278OtherAPWU
030349278OtherAIG
10002901OtherCDPIIP
030349278OtherBEBEFIRST
00019771OtherBCBS FEDERAL EMPLOYEE
030349278OtherCBA
030349278OtherAARP
3802679002OtherCIGNA
VTOVN0869Medicaid
NY56028BMedicare ID - Type Unspecified
030349278OtherAMERICAN PROGRESSIVE
VTOVN0869Medicaid
030349278OtherCBA