Individual provider Active NPI

Julie Ann Roubal, PA-C

  • Physician Assistant
  • Omaha, NE
National Provider Identifier
1114975489
Registry record updated Nov 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1132 Issued in NE
Practice address
515 N 162ND Ave Ste 203
Omaha, NE 68118-2540
Phone
(402) 354-0621
Fax
(402) 354-7380
NPI assigned
May 5, 2006
Last updated
Nov 5, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1132 NE Primary

Addresses

Primary practice location

515 N 162ND Ave Ste 203
Omaha, NE 68118-2540

Mailing address

PO Box 3755
Omaha, NE 68103-0755
Phone (402) 354-2100

Other names 1

  • Julie Ann Hoffart Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20040624000503 NE Practitioner - Physician Assistant 9032195821 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Nebraska College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Specialists of Omaha LLCGroup PAC ID 7113018581, 13 clinicians
Forefront Dermatology SCGroup PAC ID 3779471701, 650 clinicians

Practice addresses (Care Compare)

1825 N 205TH St
Elkhorn, NE 68022-4761
Phone (402) 330-4555

909 N 96TH St
Omaha, NE 68114-2508
Phone (402) 330-4555

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75.86 of 100Reported as group
Quality
46
Improvement activities
40
Cost
91.54

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Forefront Dermatology, S.C. CurrentSince Dec 2, 2025 Accepting new patients
Forefront Dermatology, S.C. CurrentSince Dec 2, 2025 Accepting new patients
Physicians Clinic Inc Physician Assistant CurrentSince Oct 31, 2026 Accepting new patients
Dermatology Surgery Center, PC Past Accepting new patients
Nebraska Methodist Hospital Physician Assistant PastSince Oct 31, 2026 Accepting new patients

Locations

1825 N 205th St
Elkhorn, NE 68022
Phone (402) 330-4555

515 N 162nd Ave
Ste 203
Omaha, NE 68118
Phone (402) 354-0621

909 N 96th St
Omaha, NE 68114
Phone (402) 330-4555

909 N 96th St
Ste 201
Omaha, NE 68114
Phone (402) 330-4555

801 York St
Manitowoc, WI 54220
Phone (866) 630-9882

Interoperability endpoints

  • Direct secure messaging: julieroubal@dsollc.allscriptsdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1793836800000",
    "number": "1114975489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3755",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681030755",
            "telephone_number": "402-354-2100",
            "fax_number": "402-354-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 N 162ND AVE STE 203",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681182540",
            "telephone_number": "402-354-0621",
            "fax_number": "402-354-7380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUBAL",
        "first_name": "JULIE",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-05",
        "last_updated": "2026-11-05",
        "certification_date": "2026-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "1132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIE",
            "last_name": "HOFFART",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.