Alan W Roetker, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

26029 Issued in WI

Practice address

421 Camelot Dr
Fond Du Lac, WI 54935-8335

Phone

(920) 926-8616

NPI assigned

Sep 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Clinic of Orthopedic Surgery CHTD

  • Orthopaedic Surgery Physician
  • Fond Du Lac, WI
  • NPI 1437240421
  NPD (past) Authorized official

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456876800000",
    "number": "1124119110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 E DIVISION ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549354560",
            "telephone_number": "920-926-8340",
            "fax_number": "920-926-8370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 CAMELOT DR",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549358335",
            "telephone_number": "920-926-8616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROETKER",
        "first_name": "ALAN",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2016-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WI",
            "license": "26029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31386600",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00861894",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer M Roberts, RN
• Stephen H Roberts, LCSW, CSAC
• Clifton A Robinson, M.D.
• Robt E. Berry Halfway House Inc.
• Jeanette Roehl, APNP FNP
• Elizabeth Scott Rogers-Doll, PHD
• Christine Rohr
• Linda Roos-Stutz
• Nydia C Ros, M.D.
• Katie Rose, BSW

• Orthopaedic Surgery Physician in Fond Du Lac, WI
• Providers in Fond Du Lac, WI by specialty
• Orthopaedic Surgery Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.