NPIMap

Individual provider Active NPI

Kurt M Roecker, D.O.

  • Family Medicine Physician
  • Lambertville, MI
National Provider Identifier
1053309393
Registry record updated May 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101013387 Issued in MI
Practice address
7581 Secor Rd
Lambertville, MI 48144-9624
Phone
(734) 856-6360
Fax
(734) 856-6364
NPI assigned
Oct 11, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 3401539 OH
Family Medicine Physician 207Q00000X 5101013387 MI Primary

Addresses

Primary practice location

7581 Secor Rd
Lambertville, MI 48144-9624

Mailing address

7581 Secor Rd
Lambertville, MI 48144-9624

Other identifiers 2

IdentifierTypeStateIssuer
4506636MedicaidMI
0855811754OtherMIBCBS OF MICHIGAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, OH2 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
I20110117000042 MI Practitioner - Family Practice 0244429603 Reassigns benefits to 2 organizations
I20240116000641 OH Practitioner - Family Practice 0244429603 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Physicians-North LLCGroup PAC ID 2668522400, 131 clinicians

Practice addresses (Care Compare)

2222 Cherry St
Toledo, OH 43608-2675

3425 Executive Pkwy
Suite 100
Toledo, OH 43606-1326
Phone (419) 472-1124

7581 Secor Rd
Mercy Health Lambertville Family
Lambertville, MI 48144-9624
Phone (734) 856-6360

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3401539OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians-North LLC Family Medicine CurrentSince Dec 11, 2023 Accepting new patients
Hillsdale Community Health Center CurrentSince Mar 31, 2018 Accepting new patients
Aspen Medical Partners LLC Family Medicine Current Accepting new patients
Mercy Health Physicians - North, LLC CurrentSince Dec 11, 2023 Accepting new patients
Mercy Health System Northern Past Accepting new patients
Major Hospital Past Accepting new patients

Locations

240 W Carleton Rd
Hillsdale, MI 49242
Phone (517) 437-7040

168 S Howell St
Hillsdale, MI 49242
Phone (517) 437-4451

7581 Secor Rd
Lambertville, MI 48144
Phone (734) 854-1800

718 N Macomb St
Monroe, MI 48162
Phone (734) 212-3097

2222 Cherry St
Ste 2300
Toledo, OH 43608
Phone (419) 251-8013

3425 Executive Pkwy
Ste 100
Toledo, OH 43606
Phone (419) 472-1124

Interoperability endpoints

  • Direct secure messaging: kroecker2482980@direct.bsmhealth.org

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 5

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": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715299200000",
    "number": "1053309393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7581 SECOR RD",
            "city": "LAMBERTVILLE",
            "state": "MI",
            "postal_code": "481449624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7581 SECOR RD",
            "city": "LAMBERTVILLE",
            "state": "MI",
            "postal_code": "481449624",
            "telephone_number": "734-856-6360",
            "fax_number": "734-856-6364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROECKER",
        "first_name": "KURT",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-11",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "3401539",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101013387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4506636",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MICHIGAN",
            "identifier": "0855811754",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lambertville, MI

Sources for this page

Verify at the official NPI Registry.