Individual provider Active NPI

Steven Kenneth Roelofs

  • Audiologist
  • Oregon City, OR
National Provider Identifier
1093263402
Registry record updated Sep 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
30866 Issued in OR
Practice address
502 Willamette St
Oregon City, OR 97045-2725
Phone
(541) 285-3322
NPI assigned
Sep 14, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 30866 OR Primary

Addresses

Primary practice location

502 Willamette St
Oregon City, OR 97045-2725

Mailing address

816 Beltline Rd
Springfield, OR 97477-1091
Phone (541) 746-7671

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210311002014 OR Practitioner - Qualified Audiologist 1355757667

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
30866ORMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Hear 360 Now Inc Audiologist Past Accepting new patients
Hear 361 Now LLC Dba Advanced Hearing Plus Audiologist Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1473811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1093263402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 BELTLINE RD",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974771091",
            "telephone_number": "541-746-7671",
            "fax_number": "541-746-2625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 WILLAMETTE ST",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970452725",
            "telephone_number": "541-285-3322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROELOFS",
        "first_name": "STEVEN",
        "middle_name": "KENNETH",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-14",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OR",
            "license": "30866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oregon City, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.