Individual provider Active NPI

James B Roush, D.P.M.

  • Podiatrist
  • Painted Post, NY
National Provider Identifier
1174631519
Registry record updated Apr 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
N004965 Issued in NY
Practice address
186 Village SQ
Painted Post, NY 14870-1320
Phone
(607) 936-9985
Fax
(607) 936-9991
NPI assigned
Aug 27, 2006
Last updated
Apr 21, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X N004965 NY Primary

Addresses

Primary practice location

186 Village SQ
Painted Post, NY 14870-1320

Mailing address

186 Village SQ
Painted Post, NY 14870-1320
Phone (607) 936-9985

Other identifiers 1

IdentifierTypeStateIssuer
01345344MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060125000175 NY Practitioner - Podiatry 3678597978 Practice locations: Bath, NY; Painted Post, NY; Hornell, NY; Horseheads, NY

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

120 Creekside Dr
Painted Post, NY 14870-9221
Phone (607) 962-5096

131 Hornell St
Hornell, NY 14843-1234
Phone (607) 324-5417

186 Village SQ
Painted Post, NY 14870-1320
Phone (607) 936-9985

3005 Watkins Rd
Horseheads, NY 14845-1800
Phone (607) 739-8711

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1270
Removal or shaving of skin growth918

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
N004965NYMDPodiatrist
004965NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Able 2 Enhancing Potential Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461196800000",
    "number": "1174631519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "186 VILLAGE SQ",
            "city": "PAINTED POST",
            "state": "NY",
            "postal_code": "148701320",
            "telephone_number": "607-936-9985",
            "fax_number": "607-936-9991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "186 VILLAGE SQ",
            "city": "PAINTED POST",
            "state": "NY",
            "postal_code": "148701320",
            "telephone_number": "607-936-9985",
            "fax_number": "607-936-9991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUSH",
        "first_name": "JAMES",
        "middle_name": "B",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-27",
        "last_updated": "2016-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N004965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01345344",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Painted Post, NY

Sources for this page

Verify at the official NPI Registry.