NPIMap

Individual provider Active NPI

Aime Kouadio Roger

  • Internal Medicine Physician
  • Croydon, PA
National Provider Identifier
1093832503
Registry record updated May 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD070267L Issued in PA
Practice address
817 Orchard Ave
Croydon, PA 19021-6942
Phone
(215) 785-3308
Fax
(215) 785-3308
NPI assigned
Mar 22, 2007
Last updated
May 29, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD070267L PA Primary

Addresses

Primary practice location

817 Orchard Ave
Croydon, PA 19021-6942

Mailing address

817 Orchard Avenue
Croydon, PA 19021
Phone (215) 785-3308

Other names 1

  • Dr. Aime Kouadio Roger Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20080516000281 PA Practitioner - Internal Medicine 1951470947 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Hahnemann University College of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Upmc AltoonaGroup PAC ID 8426962465, 126 clinicians

Practice addresses (Care Compare)

2 Hot Meal St
Pittsburgh, PA 15203-2348

620 Howard Ave
Altoona, PA 16601-4804
Phone (814) 889-2866

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD070267LPAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Upmc Altoona CurrentSince Mar 30, 2015 Accepting new patients
Upmc Altoona CurrentSince Mar 30, 2015 Accepting new patients
Upmc Altoona Past Accepting new patients

Locations

620 Howard Ave
Altoona, PA 16601
Phone (814) 889-2011

620 Howard Ave
#302
Altoona, PA 16601
Phone (814) 889-2011

620 Howard Ave
Fl Fifth
Altoona, PA 16601
Phone (814) 889-2223

Interoperability endpoints

  • Direct secure messaging: aroger214698@upmc.direct-ci.com

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 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212019200000",
    "number": "1093832503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 ORCHARD AVENUE",
            "city": "CROYDON",
            "state": "PA",
            "postal_code": "19021",
            "telephone_number": "215-785-3308",
            "fax_number": "215-785-3308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 ORCHARD AVE",
            "city": "CROYDON",
            "state": "PA",
            "postal_code": "190216942",
            "telephone_number": "215-785-3308",
            "fax_number": "215-785-3308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGER",
        "first_name": "AIME",
        "middle_name": "KOUADIO",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-22",
        "last_updated": "2008-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD070267L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AIME",
            "last_name": "ROGER",
            "middle_name": "KOUADIO",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Croydon, PA

Sources for this page

Verify at the official NPI Registry.