Active NPI
Gavin Roache, NP
- Adult Health Nurse Practitioner
- Harrisburg, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- SP021669
- Practice address
- 111 S Front St
Harrisburg, PA 17101-2010 - Phone
- (717) 782-3131
- NPI assigned
- Jul 16, 2014
- Last updated
- Apr 16, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | SP021669 | PA | Primary |
| Family Nurse Practitioner | 363LF0000X | APRN11004127 | FL | |
| Family Nurse Practitioner | 363LF0000X | SP021669 | PA |
Addresses
Primary practice location
111 S Front St
Harrisburg, PA 17101-2010
Mailing address
111 S Front St
Harrisburg, PA 17101-2010
Phone (863) 370-9555
Other practice location 1
1995 Technology Pkwy
Mechanicsburg, PA 17050-8522
Phone (717) 988-0000
Other practice location 2
4300 Londonderry Rd
Harrisburg, PA 17109-5317
Phone (717) 988-0000
Other practice location 3
300 Highland Ave
Hanover, PA 17331-2297
Phone (717) 988-0000
Other practice location 4
361 Alexander Spring Rd
Carlisle, PA 17015-6940
Phone (717) 988-0000
Other practice location 5
1701 Innovation Dr
York, PA 17408-8815
Phone (717) 988-0000
Other practice location 6
1701 Innovation Dr
York, PA 17408-8815
Phone (717) 988-0000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 016388100 | Medicaid | FL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | groache172004@phsdirect.pinnaclehealth.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA, VA, WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
111 S Front St
Pinnacle HLTH ER Dept SVC LLC
Harrisburg, PA 17101-2010
Phone (717) 988-0000
6801 Gov G C Peery Hwy
Richlands, VA 24641
Phone (276) 596-6000
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.46 of 100
- Quality
- 92.17
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 78.87
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN11004127 | FL | MD | Family Nurse Practitioner |
| SP021669 | PA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emergency Coverage, LLC | Current | Accepting new patients | |
| Pinnacle Health Emergency Department Services LLC | Current | Accepting new patients |
Locations
361 Alexander Spring Rd
Carlisle, PA 17015
Phone (717) 249-1211
300 Highland Ave
Hanover, PA 17331
Phone (717) 316-3711
111 S Front St
Harrisburg, PA 17101
Phone (717) 782-3282
4300 Londonderry Rd
Lower Paxton, PA 17109
Phone (717) 597-7044
1995 Technology Pkwy
Mechanicsburg, PA 17050
Phone (717) 791-2600
1701 Innovation Dr
York, PA 17408
Phone (717) 843-8623
Interoperability endpoints
- groache301168@upmc.direct-ci.com
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Emergency Medicine Physician
- Harrisburg, PA
- NPI 1487693404
-
dba Emergency Coverage Corporation of TeamHealth
- Family Medicine Physician
- Newport, TN
- NPI 1427005008
VA
-
dba Aspirus Gilman Clinic
- Rural Health Clinic/Center
- Gilman, WI
- NPI 1285703173
-
dba Aspirus Medford Hospital
- Critical Access Hospital
- Medford, WI
- NPI 1619079597
Hospital & facility affiliations 9
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Aspirus Therapy & Fitness - Medford
- Rehabilitation Clinic/Center
- Medford, WI
- NPI 1104922814
Hospital
-
dba Aspirus Therapy - Prentice
- Rehabilitation Hospital Unit
- Prentice, WI
- NPI 1154468205
-
dba Aspirus Rib Lake Clinic
- Rural Health Clinic/Center
- Rib Lake, WI
- NPI 1265502173
Hospital
-
dba Aspirus Gilman Clinic
- Rural Health Clinic/Center
- Gilman, WI
- NPI 1285703173
Hospital
-
dba Aspirus Medford Clinic
- Rural Health Clinic/Center
- Medford, WI
- NPI 1427140649
Hospital
-
dba Aspirus Medford Hospital
- Critical Access Hospital
- Medford, WI
- NPI 1619079597
-
dba Aspirus Prentice Clinic
- Rural Health Clinic/Center
- Prentice, WI
- NPI 1710066584
Hospital
-
dba Aspirus Athens Clinic
- Rural Health Clinic/Center
- Athens, WI
- NPI 1760912919
Hospital
-
dba Wythe County Community Hospital
- Rural Acute Care Hospital
- Wytheville, VA
- NPI 1184706152
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1405468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618531200000",
"number": "1023425600",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 S FRONT ST",
"city": "HARRISBURG",
"state": "PA",
"postal_code": "171012010",
"telephone_number": "863-370-9555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 S FRONT ST",
"city": "HARRISBURG",
"state": "PA",
"postal_code": "171012010",
"telephone_number": "717-782-3131"
}
],
"practiceLocations": [
{
"address_1": "1995 Technology Pkwy",
"address_purpose": "LOCATION",
"city": "Mechanicsburg",
"state": "PA",
"postal_code": "170508522",
"country_code": "US",
"telephone_number": "717-988-0000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4300 Londonderry Rd",
"address_purpose": "LOCATION",
"city": "Harrisburg",
"state": "PA",
"postal_code": "171095317",
"country_code": "US",
"telephone_number": "717-988-0000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "300 Highland Ave",
"address_purpose": "LOCATION",
"city": "Hanover",
"state": "PA",
"postal_code": "173312297",
"country_code": "US",
"telephone_number": "717-988-0000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "361 Alexander Spring Rd",
"address_purpose": "LOCATION",
"city": "Carlisle",
"state": "PA",
"postal_code": "170156940",
"country_code": "US",
"telephone_number": "717-988-0000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1701 Innovation Dr",
"address_purpose": "LOCATION",
"city": "York",
"state": "PA",
"postal_code": "174088815",
"country_code": "US",
"telephone_number": "717-988-0000",
"fax_number": "717-782-5716",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1701 Innovation Dr",
"address_purpose": "LOCATION",
"city": "York",
"state": "PA",
"postal_code": "174088815",
"country_code": "US",
"telephone_number": "717-988-0000",
"fax_number": "717-782-5716",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROACHE",
"first_name": "GAVIN",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-07-16",
"last_updated": "2021-04-16",
"certification_date": "2021-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "PA",
"license": "SP021669",
"primary": true
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "FL",
"license": "APRN11004127",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "PA",
"license": "SP021669",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "016388100",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "groache172004@phsdirect.pinnaclehealth.org",
"affiliation": "N",
"address_1": "111 S Front St",
"city": "Harrisburg",
"state": "PA",
"country_code": "US",
"postal_code": "171012010",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Harrisburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.