NPIMap

Individual provider Active NPI

Marisa J. Roach, PA

  • Medical Physician Assistant
  • Rochester, NY
National Provider Identifier
1275794083
Registry record updated Nov 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
012611 Issued in NY
Practice address
1555 Long Pond Rd
Emergency Center
Rochester, NY 14626-4122
Phone
(585) 723-7070
Fax
(585) 723-7083
NPI assigned
Jun 24, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 012611 NY Primary

Addresses

Primary practice location

1555 Long Pond Rd
Emergency Center
Rochester, NY 14626-4122

Mailing address

1555 Long Pond Rd
Emergency Center
Rochester, NY 14626-4122
Phone (585) 723-7070

Other identifiers 2

IdentifierTypeStateIssuer
P01518713OtherNYMEDICARE RR
03034177MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080724000294 NY Practitioner - Physician Assistant 3274606264 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Unity Hospital of RochesterGroup PAC ID 9436060969, 732 clinicians

Practice addresses (Care Compare)

1425 Portland Ave
Rochester, NY 14621-3001
Phone (585) 922-3122

1555 Long Pond Rd
Rochester, NY 14626-4122
Phone (585) 429-2289

1565 Long Pond Rd
Rochester, NY 14626-4122
Phone (585) 723-7366

158 Orchard St
Rochester, NY 14611-1361
Phone (585) 368-4500

2420 Ridgeway Ave
Rochester, NY 14626-4114
Phone (585) 227-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as apm
Quality
74.51
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as apm
Quality
74.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Unity Hospital of Rochester CurrentSince Jul 9, 2008 Accepting new patients
Western New York Medical Practice, P.C. CurrentSince May 10, 2021 Accepting new patients
Western New York Medical Practice P.C. CurrentSince May 10, 2021 Accepting new patients
Rochester General Hospital CurrentSince Oct 1, 2021 Accepting new patients
Rochester General Hospital CurrentSince Oct 1, 2021 Accepting new patients

Locations

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

1555 Long Pond Rd
Rochester, NY 14626
Phone (585) 429-2289

Interoperability endpoints

  • Direct secure messaging: mroach174875@direct.rochestergeneral.org
  • Direct secure messaging: mroach@cfu.medentdirect.com

Organizations & group practices 7

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 9

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": "1214265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446595200000",
    "number": "1275794083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 LONG POND RD",
            "address_2": "EMERGENCY CENTER",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146264122",
            "telephone_number": "585-723-7070",
            "fax_number": "585-723-7083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 LONG POND RD",
            "address_2": "EMERGENCY CENTER",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146264122",
            "telephone_number": "585-723-7070",
            "fax_number": "585-723-7083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROACH",
        "first_name": "MARISA",
        "middle_name": "J.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-24",
        "last_updated": "2015-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "012611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P01518713",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03034177",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.