Individual provider Active NPI

Steven Gale Roshon, M.D.

  • Hematology & Oncology Physician
  • Sandusky, OH
National Provider Identifier
1174500383
Registry record updated Jan 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
35044393R Issued in OH
Practice address
417 Quarry Lakes Dr.
Sandusky, OH 44870-4132
Phone
(419) 626-9090
Fax
(419) 626-6319
NPI assigned
Dec 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 35044393R OH Primary

Addresses

Primary practice location

417 Quarry Lakes Dr.
Sandusky, OH 44870-4132

Mailing address

417 Quarry Lakes Dr.
Sandusky, OH 44870-4132
Phone (419) 626-9090

Other identifiers 6

IdentifierTypeStateIssuer
110040853OtherOHRAILROAD MEDICARE
514269MedicaidOH
03540OtherOHPARAMOUNT
000000128757OtherOHANTHEM
68543877-001OtherOHMEDICAL MUTUAL OF OHIO
RO0542192OtherOHMEDICARE PROVIDER #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35044393ROHMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Coast Cancer Care, Inc Hematology & Oncology CurrentSince Jul 29, 1984 Accepting new patients
Cleveland Clinic Florida a Nonprofit Corporation Past Accepting new patients

Locations

509 W McPherson Hwy
Clyde, OH 43410
Phone (419) 547-0524

272 Benedict Ave
Norwalk, OH 44857
Phone (419) 668-1341

417 Quarry Lakes Dr
Sandusky, OH 44870
Phone (419) 609-2845

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.

NPI Registry JSON

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

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199232000000",
    "number": "1174500383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 QUARRY LAKES DR.",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448704132",
            "telephone_number": "419-626-9090",
            "fax_number": "419-626-6319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 QUARRY LAKES DR.",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448704132",
            "telephone_number": "419-626-9090",
            "fax_number": "419-626-6319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSHON",
        "first_name": "STEVEN",
        "middle_name": "GALE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-29",
        "last_updated": "2008-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "OH",
            "license": "35044393R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110040853",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "514269",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARAMOUNT",
            "identifier": "03540",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000128757",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL MUTUAL OF OHIO",
            "identifier": "68543877-001",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER #",
            "identifier": "RO0542192",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandusky, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2008; 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.