Individual provider Active NPI

Christopher Bernard Roskopp, D.O.

  • Emergency Medicine Physician
  • Port Huron, MI
National Provider Identifier
1104127760
Registry record updated Mar 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
5101019031 Issued in MI
Practice address
1221 Pine Grove Ave
Emergency Medicine Department
Port Huron, MI 48060-3511
Phone
(810) 989-3300
Fax
(810) 985-2671
NPI assigned
Nov 12, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 5101019031 MI Primary

Addresses

Primary practice location

1221 Pine Grove Ave
Emergency Medicine Department
Port Huron, MI 48060-3511

Mailing address

1221 Pine Grove Ave
Emergency Medicine Department
Port Huron, MI 48060-3511
Phone (810) 989-3300

Other identifiers 1

IdentifierTypeStateIssuer
1104127760MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20140805002443 MI Practitioner - Emergency Medicine 3072730696 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Michigan State University College of Osteopathic Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Huron Emergency Medicine Specialists PLLCGroup PAC ID 9032538830, 8 clinicians

Practice addresses (Care Compare)

1221 Pine Grove Ave
Port Huron, MI 48060-3511
Phone (810) 989-3300

Hospital & facility affiliations

  • McLaren Port Huron Hospital, Port Huron, MI, CCN 230216

Merit-based Incentive Payment System (MIPS)

Final score
98.08 of 100Reported as group
Quality
89.29
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101019031MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Huron Emergency Medicine Specialists, PLLC Emergency Medicine CurrentSince Oct 1, 2020 Accepting new patients

Locations

1221 Pine Grove Ave
Port Huron, MI 48060
Phone (810) 989-3300

Organizations & group practices 1

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": "1289520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520294400000",
    "number": "1104127760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 PINE GROVE AVE",
            "address_2": "EMERGENCY MEDICINE DEPARTMENT",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603511",
            "telephone_number": "810-989-3300",
            "fax_number": "810-985-2671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 PINE GROVE AVE",
            "address_2": "EMERGENCY MEDICINE DEPARTMENT",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603511",
            "telephone_number": "810-989-3300",
            "fax_number": "810-985-2671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSKOPP",
        "first_name": "CHRISTOPHER",
        "middle_name": "BERNARD",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-12",
        "last_updated": "2018-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101019031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104127760",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Huron, MI

Sources for this page

Verify at the official NPI Registry.