NPIMap

Individual provider Active NPI

Matthew Joseph Roller, MD

  • Neurology Physician
  • Grand Forks, ND
National Provider Identifier
1033283379
Registry record updated Jul 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
10400 Issued in ND
Practice address
1300 S Columbia Rd
Grand Forks, ND 58201
Phone
(701) 780-2300
NPI assigned
Nov 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 50324 MN
Neurology Physician 2084N0400X 10400 ND Primary

Addresses

Primary practice location

1300 S Columbia Rd
Grand Forks, ND 58201

Mailing address

2401 Demers Ave
Grand Forks, ND 58201
Phone (701) 780-1891

Other practice location 1

711 Delores Drive
Roseau, MN 56751
Phone (701) 317-9000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mroller2516@direct.directaltru.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, MN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070109000194 ND Practitioner - Neurology 6507866977 Reassigns benefits to 1 organization
I20080611000685 MN Practitioner - Neurology 6507866977 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of North Dakota School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4399 S Columbia Rd
Suite 104
Grand Forks, ND 58201-2833
Phone (701) 317-9000

711 Delmore Dr
Roseau, MN 56751-1534
Phone (701) 317-9000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
50324MNMDNeurology Physician
10400NDMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Altru Health System Current Accepting new patients
Altru Health System Current Accepting new patients
Roller Neurology Neurology CurrentSince Apr 1, 2021 Accepting new patients
Altru Health System CurrentSince Feb 1, 2008 Accepting new patients
Rehabilitation Hospital of Grand Forks, LLC Past Accepting new patients
Clinic Pharmacy Inc Past Accepting new patients

Locations

400 S Minnesota St
Crookston, MN 56716
Phone (218) 281-9100

711 Delmore Dr
Roseau, MN 56751
Phone (218) 463-1365

201 E 3rd Ave S
Cavalier, ND 58220
Phone (701) 265-8338

1001 7th St NE
Devils Lake, ND 58301
Phone (701) 662-2157

164 W 13th St
Grafton, ND 58237
Phone (701) 352-1620

1380 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 795-2000

1000 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 780-5089

1300 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 780-2300

4399 S Columbia Rd
Ste 104
Grand Forks, ND 58201
Phone (701) 317-9000

Interoperability endpoints

  • Direct secure messaging: mroller2516@direct.directaltru.org
  • Direct secure messaging: matthew.roller.1@23534.direct.athenahealth.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627344000000",
    "number": "1033283379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 DEMERS AVE",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "58201",
            "telephone_number": "701-780-1891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 S COLUMBIA RD",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "58201",
            "telephone_number": "701-780-2300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "711 Delores Drive",
            "address_purpose": "LOCATION",
            "city": "Roseau",
            "state": "MN",
            "postal_code": "56751",
            "country_code": "US",
            "telephone_number": "701-317-9000",
            "fax_number": "833-673-0535",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROLLER",
        "first_name": "MATTHEW",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2021-07-27",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MN",
            "license": "50324",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "ND",
            "license": "10400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mroller2516@direct.directaltru.org",
            "affiliation": "N",
            "endpointDescription": "direct mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1300 S Columbia Rd",
            "city": "Grand Forks",
            "state": "ND",
            "country_code": "US",
            "postal_code": "58201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grand Forks, ND

Sources for this page

Verify at the official NPI Registry.