Roanne Jimenez

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

61407688 Issued in WA

Practice address

Corner of Route N12 and N7
Fort Defiance, AZ 86504

Phone

(928) 729-8000

NPI assigned

Apr 12, 2023

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

Medicare fee-for-service enrollment

Enrolled in WA, TX2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Family Health CentersGroup PAC ID 9739076217, 31 clinicians

The Fort Defiance Indian Hospital Board, IncorporationGroup PAC ID 0941336697, 153 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fort Defiance Indian Hospital Hospital, Ft. Defiance, AZ, CCN 030071
• Mid Valley Hospital & Clinic Hospital, Omak, WA, CCN 501328

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• The Fort Defiance Indian Hospital Board, Incorporation

  • General Acute Care Hospital
  • Fort Defiance, AZ
  • NPI 1477876639

  TX

  Medicare reassignment Care Compare group NPD
• Family Health Centers

  • Federally Qualified Health Center (FQHC)
  • Okanogan, WA
  • NPI 1609804392

  WA

  Medicare reassignment Care Compare group NPD
• Okanogan County Public Hospital District No. 3

  • Critical Access Hospital
  • Omak, WA
  • NPI 1255387403

  WA

  Medicare reassignment NPD
• Family Health Centers

  • Federally Qualified Health Center (FQHC)
  • Twisp, WA
  • NPI 1679962401
  Care Compare group NPD
• Sea Mar Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Aberdeen, WA
  • NPI 1811051170

  WA

  Medicare reassignment
• The Fort Defiance Indian Hospital Board, Incorporation

  • Ambulatory Surgical Clinic/Center
  • Fort Defiance, AZ
  • NPI 1487977914
  Care Compare group
• Family Health Centers

  • Federally Qualified Health Center (FQHC)
  • Tonasket, WA
  • NPI 1184883449
  Care Compare group
• Family Health Centers

  • Federally Qualified Health Center (FQHC)
  • Omak, WA
  • NPI 1306005715
  Care Compare group
• Family Health Centers

  • Federally Qualified Health Center (FQHC)
  • Bridgeport, WA
  • NPI 1497176390
  Care Compare group
• Family Health Centers

  • Federally Qualified Health Center (FQHC)
  • Brewster, WA
  • NPI 1629237482
  Care Compare group
• Sea Mar Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Mount Vernon, WA
  • NPI 1528115870

  Physician Assistant

  NPD
• Sea Mar Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Spanaway, WA
  • NPI 1922624642
  NPD

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

• Okanogan County Public Hospital District No. 3

  • Critical Access Hospital
  • Omak, WA
  • NPI 1255387403

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1681257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764288000000",
    "number": "1245926443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 649",
            "city": "FORT DEFIANCE",
            "state": "AZ",
            "postal_code": "865040649",
            "telephone_number": "928-729-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CORNER OF ROUTE N12 AND N7",
            "city": "FORT DEFIANCE",
            "state": "AZ",
            "postal_code": "86504",
            "telephone_number": "928-729-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "ROANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-12",
        "last_updated": "2025-11-28",
        "certification_date": "2025-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "61407688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacquelyn James, CRNA
• Lilia Janzen-Trotsyuk
• Gregory Jarrin, MD
• Michael R. Jarvis, D.O.
• Malcolm Jewell, PA-C
• Kendall Rae John
• Mae Y John, MS CF SLP
• Illya Johnson-Hicklen, RCP
• Roberta S. Johnson-Seay, ARNP-C
• Berdie E Johnson, BSW

• All providers in Fort Defiance, AZ
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.