Individual provider Active NPI

David M Roll, M.D.

  • Internal Medicine Physician
  • Revere, MA
National Provider Identifier
1194824417
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
220252 Issued in MA
Practice address
Revere Family Health Center
454 Broadway
Revere, MA 02151
Phone
(781) 485-8222
NPI assigned
Sep 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 220252 MA Primary

Addresses

Primary practice location

Revere Family Health Center
454 Broadway
Revere, MA 02151

Mailing address

21 Mague PL
Newton, MA 02465-1539
Phone (781) 485-8222

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040816001331 MA Practitioner - Internal Medicine 6103899398 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Johns Hopkins University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

103 Garland St
Everett, MA 02149-5066
Phone (617) 389-6270

Hospital & facility affiliations

  • Mass General Brigham Home Care, Inc Home health agency, Newton, MA, CCN 227207
  • All Care Vna-Greater Lynn Inc Home health agency, Lynn, MA, CCN 227263
  • Cambridge Health Alliance Hospital, Cambridge, MA, CCN 220011
  • Massachusetts General Hospital Hospital, Boston, MA, CCN 220071

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cambridge Public Health Commission Current Accepting new patients
Cambridge Public Health Commission CurrentSince Sep 1, 2005 Accepting new patients

Locations

1493 Cambridge St
Cambridge, MA 02139
Phone (617) 665-1185

391 Broadway
Ste 204
Everett, MA 02149
Phone (617) 387-0473

103 Garland St
Everett, MA 02149
Phone (617) 381-7150

350 Main St
Ste 31
Malden, MA 02148
Phone (781) 397-6583

454 Broadway
Revere, MA 02151
Phone (617) 389-4666

Interoperability endpoints

  • Direct secure messaging: droll706@direct.challiance.masshiway.net

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 5

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

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194824417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 MAGUE PL",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024651539",
            "telephone_number": "781-485-8222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "REVERE FAMILY HEALTH CENTER",
            "address_2": "454 BROADWAY",
            "city": "REVERE",
            "state": "MA",
            "postal_code": "02151",
            "telephone_number": "781-485-8222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLL",
        "first_name": "DAVID",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "220252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Revere, MA

Sources for this page

Verify at the official NPI Registry.