Individual provider Active NPI

Gabrielle Nicole Roux

  • Surgical Physician Assistant
  • Medina, OH
National Provider Identifier
1073227708
Registry record updated Apr 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
1000 E Washington St
Medina, OH 44256-2170
Phone
(330) 725-1000
NPI assigned
Jan 9, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X Primary

Addresses

Primary practice location

1000 E Washington St
Medina, OH 44256-2170

Mailing address

5001 Green Ash TRL
Medina, OH 44256-5575
Phone (248) 895-2504

Other practice location 1

1000 E Washington St
Medina, OH 44256-2170
Phone (330) 725-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240627002310 OH Practitioner - Physician Assistant 0648714956 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medina HospitalGroup PAC ID 3072410125, 25 clinicians

Practice addresses (Care Compare)

1000 E Washington St
Medina, OH 44256-2170
Phone (330) 725-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Medina Hospital CurrentSince Mar 7, 2024 Accepting new patients
Medina Hospital CurrentSince Mar 7, 2024 Accepting new patients

Locations

1000 E Washington St
Medina, OH 44256
Phone (330) 654-1185

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

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 1

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": "1673222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1073227708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 GREEN ASH TRL",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442565575",
            "telephone_number": "248-895-2504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E WASHINGTON ST",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442562170",
            "telephone_number": "330-725-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 E Washington St",
            "address_purpose": "LOCATION",
            "city": "Medina",
            "state": "OH",
            "postal_code": "442562170",
            "country_code": "US",
            "telephone_number": "330-725-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROUX",
        "first_name": "GABRIELLE",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-09",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medina, OH

Sources for this page

Verify at the official NPI Registry.