Samantha Roesch, CRNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

SP009229 Issued in PA

Practice address

100 E Lancaster Ave
The Heart Pavilion, Mezzanine Level
Wynnewood, PA 19096-3450

Phone

(484) 476-1000

Fax

(484) 476-9000

NPI assigned

Apr 22, 2008

Sex

Female

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 1

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Main Line Healthcare

  • Family Medicine Physician
  • Newtown Square, PA
  • NPI 1922077643
  Medicare reassignment NPD

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

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435017600000",
    "number": "1144494170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE",
            "address_2": "THE HEART PAVILION, MEZZANINE LEVEL",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963450",
            "telephone_number": "484-476-1000",
            "fax_number": "484-476-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE",
            "address_2": "THE HEART PAVILION, MEZZANINE LEVEL",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963450",
            "telephone_number": "484-476-1000",
            "fax_number": "484-476-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROESCH",
        "first_name": "SAMANTHA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-22",
        "last_updated": "2015-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP009229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MLHC TAX ID",
            "identifier": "23-2359401",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paul Sylvester Robbins, DO
• Nancy Sue Roberts, M.D.
• Catherine Robinson, OTD, OTR/L
• Lillian Patrice Rodgers, PA-C
• Amanda Rodriguez
• Gail Roeshman, L.S.W.
• Cynthia Rogalski, MD
• Sophia Rokkas
• Jeanine Romanelli, MD
• Mihai Radu Romanovschi, MD

• Adult Health Nurse Practitioner in Wynnewood, PA
• Providers in Wynnewood, PA by specialty
• Adult Health Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.