NPIMap

Individual provider Active NPI

Robert G Roach, D.O.

  • Family Medicine Physician
  • Crosby, TX
National Provider Identifier
1043259807
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
K9887 Issued in TX
Practice address
14700 FM 2100 Rd
Suite a
Crosby, TX 77532-9161
Phone
(281) 328-2568
Fax
(281) 328-2039
NPI assigned
Jun 6, 2006
Last updated
Apr 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X K9887 TX Primary

Addresses

Primary practice location

14700 FM 2100 Rd
Suite a
Crosby, TX 77532-9161

Mailing address

14700 FM 2100 Rd
Suite a
Crosby, TX 77532-9161
Phone (281) 328-2568

Other identifiers 2

IdentifierTypeStateIssuer
049972003MedicaidTX
8P1990OtherTXBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040609000986 TX Practitioner - Family Practice 5698758894 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of North Texas HSC, College of Osteopathic Med, 1997
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

14700 FM 2100 Rd
Suite a
Crosby, TX 77532-9161

14700 FM 2100 Rd
Suite a
Crosby, TX 77532-9162
Phone (281) 328-2568

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
K9887TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Family & Preventive Medicine, PA Family Medicine CurrentSince Jun 1, 2004 Accepting new patients
Kelsey-Seybold Medical Group, PLLC Family Medicine Past Accepting new patients
San Jacinto Medical Group Family Medicine Past Accepting new patients

Locations

14700 FM 2100 Rd
Ste A
Crosby, TX 77532
Phone (281) 328-2568

14626 FM 2100 Rd
Ste C
Crosby, TX 77532
Phone (281) 328-2568

Interoperability endpoints

  • Direct secure messaging: rroach378630@directhoustonmethodist.org

Organizations & group practices 3

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.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1043259807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14700 FM 2100 RD",
            "address_2": "SUITE A",
            "city": "CROSBY",
            "state": "TX",
            "postal_code": "775329161",
            "telephone_number": "281-328-2568",
            "fax_number": "281-328-2039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14700 FM 2100 RD",
            "address_2": "SUITE A",
            "city": "CROSBY",
            "state": "TX",
            "postal_code": "775329161",
            "telephone_number": "281-328-2568",
            "fax_number": "281-328-2039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROACH",
        "first_name": "ROBERT",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K9887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "049972003",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8P1990",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crosby, TX

Sources for this page

Verify at the official NPI Registry.