Individual provider Active NPI

Julie Ann Roubal, PA-C

  • Physician Assistant
  • Omaha, NE
National Provider Identifier
1114975489
Registry record updated Feb 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1132 Issued in NE
Practice address
909 N 96TH St
Omaha, NE 68114-2497
Phone
(402) 330-4555
Fax
(402) 330-4626
NPI assigned
May 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 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

909 N 96TH St
Omaha, NE 68114-2497

Mailing address

801 York St
Manitowoc, WI 54220-4630
Phone (920) 663-9008

Other practice location 1

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

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

  • The Nebraska Medical Center Hospital, Omaha, NE, CCN 280013

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
Dermatology Surgery Center, PC Past Accepting new patients

Locations

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

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 4

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": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771372800000",
    "number": "1114975489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-663-9008",
            "fax_number": "920-684-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 N 96TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681142497",
            "telephone_number": "402-330-4555",
            "fax_number": "402-330-4626"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1825 N 205TH ST",
            "address_purpose": "LOCATION",
            "city": "ELKHORN",
            "state": "NE",
            "postal_code": "680224761",
            "country_code": "US",
            "telephone_number": "402-330-4555",
            "fax_number": "402-330-4626",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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": "2026-02-18",
        "certification_date": "2026-02-18",
        "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.