NPIMap

Individual provider Active NPI

Brent Allen Roach, MD

  • Diagnostic Radiology Physician
  • Louisville, KY
National Provider Identifier
1154683357
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD0000051186 Issued in TN
Practice address
1 Audubon Plaza Dr
Louisville, KY 40217-1318
Phone
(502) 447-8786
Fax
(502) 447-8623
NPI assigned
Jun 13, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD0000051186 TN Primary

Addresses

Primary practice location

1 Audubon Plaza Dr
Louisville, KY 40217-1318

Mailing address

5129 Dixie Hwy Ste 100
Louisville, KY 40216-1727
Phone (502) 447-8786

Other practice location 1

4001 Dutchmans Ln # 276
Louisville, KY 40207-4714
Phone (502) 447-8786

Other identifiers 2

IdentifierTypeStateIssuer
7100478060MedicaidKY
300017227MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180524002061 KY Practitioner - Diagnostic RadiologyPractitioner - Interventional Pain Management 2264735620 Reassigns benefits to 1 organization
I20240617003484 IN Practitioner - Diagnostic Radiology 2264735620 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Louisville School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Diagnostic X-Ray Physicians, PSCGroup PAC ID 1355239534, 36 clinicians

Practice addresses (Care Compare)

1220 Missouri Ave
Jeffersonville, IN 47130-3725
Phone (502) 447-8786

4001 Dutchmans LN
Louisville, KY 40207-4714
Phone (502) 893-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.52 of 100Reported as group
Quality
100
Improvement activities
40
Cost
91.74

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Diagnostic X-Ray Physicians, PSC Diagnostic Radiology CurrentSince Jun 1, 2018 Accepting new patients
Tuhc Radiology Group LLC Diagnostic Radiology PastSince Jul 1, 2017 Accepting new patients

Locations

2021 Mercy Way
Ste 102
Jeffersonville, IN 47130
Phone (812) 218-4630

1220 Missouri Ave
Jeffersonvlle, IN 47130
Phone (812) 282-2072

1451 N Gardner St
Scottsburg, IN 47170
Phone (812) 752-8500

130 Hunter Station Way
Sellersburg, IN 47172
Phone (812) 246-4808

157 Towne Dr
Ste 101
Elizabethtown, KY 42701
Phone (270) 740-5201

1 Audubon Plaza Dr
Louisville, KY 40217
Phone (502) 634-6767

9152 Taylorsville Rd
Louisville, KY 40299
Phone (502) 424-5635

850 S 28th St
Louisville, KY 40211
Phone (502) 629-7650

5129 Dixie Hwy
Ste 100
Louisville, KY 40216
Phone (502) 447-3242

9344 Cedar Center Way
Louisville, KY 40291
Phone (502) 753-3390

3991 Dutchmans Ln
Ste 208
Louisville, KY 40207
Phone (502) 897-2440

Organizations & group practices 2

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 41

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1339545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1154683357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5129 DIXIE HWY STE 100",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402161727",
            "telephone_number": "502-447-8786",
            "fax_number": "502-447-8623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 AUDUBON PLAZA DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402171318",
            "telephone_number": "502-447-8786",
            "fax_number": "502-447-8623"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4001 Dutchmans Ln # 276",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402074714",
            "country_code": "US",
            "telephone_number": "502-447-8786",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROACH",
        "first_name": "BRENT",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-13",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TN",
            "license": "MD0000051186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100478060",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300017227",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.