Individual provider Active NPI

Kelley Roach, DO

  • Anesthesiology Physician
  • Miami, FL
National Provider Identifier
1043892300
Registry record updated Jul 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
OS22164 Issued in FL
Practice address
3663 S Miami Ave
Miami, FL 33133-4253
Phone
(305) 854-4400
NPI assigned
Apr 26, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X OS22164 FL Primary

Addresses

Primary practice location

3663 S Miami Ave
Miami, FL 33133-4253

Mailing address

3737 Peacock Ave Apt 326
Miami, FL 33146-2866

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250807002316 FL Practitioner - Anesthesiology 0446620009 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Alabama College of Osteopathic Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3663 S Miami Ave
Miami, FL 33133-4253
Phone (954) 939-5000

Hospital & facility affiliations

  • HCA Florida Mercy Hospital Hospital, Plantation, FL, CCN 100167

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Physician Solutions of South Florida, LLC Anesthesiology Current Accepting new patients
Anesthesia Physician Solutions of South Florida, LLC Anesthesiology CurrentSince Jul 1, 2025 Accepting new patients

Locations

5301 S Congress Ave
Lantana, FL 33462
Phone (561) 548-3549

3663 S Miami Ave
Miami, FL 33133
Phone (305) 285-2131

11750 SW 40th St
Miami, FL 33175
Phone (305) 227-5544

7201 N University Dr
Tamarac, FL 33321
Phone (954) 721-2200

Organizations & group practices 2

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 2

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": "1619395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752710400000",
    "number": "1043892300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 PEACOCK AVE APT 326",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331462866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3663 S MIAMI AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331334253",
            "telephone_number": "305-854-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROACH",
        "first_name": "KELLEY",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-26",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "OS22164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.