Individual provider Active NPI

Alan B Roessler, M.D.

  • Pediatrics Physician
  • Horseheads, NY
National Provider Identifier
1295770352
Registry record updated Mar 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
130308 Issued in NY
Practice address
3344 Chambers Rd
Horseheads, NY 14845-1403
Phone
(607) 734-2264
Fax
(607) 734-2932
NPI assigned
Jun 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 130308 NY Primary

Addresses

Primary practice location

3344 Chambers Rd
Horseheads, NY 14845-1403

Mailing address

1 Guthrie SQ
Sayre, PA 18840-1625
Phone (570) 888-5858

Other practice location 1

254 E 1st St
Corning, NY 14830-2925
Phone (607) 937-5317

Other identifiers 2

IdentifierTypeStateIssuer
161355553OtherBUSINESS TAX ID
00372665MedicaidNY

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180501001297 NY Practitioner - Pediatric Medicine 1951665876 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Guthrie Medical Group, P.C. CurrentSince May 1, 2018 Accepting new patients
Guthrie Medical Group, P.C. CurrentSince May 1, 2018 Accepting new patients

Locations

130 Center Way
Corning, NY 14830
Phone (607) 936-9971

3344 Chambers Rd
Horseheads, NY 14845
Phone (607) 734-2264

1 Guthrie Sq
Sayre, PA 18840
Phone (570) 887-3106

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": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522368000000",
    "number": "1295770352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GUTHRIE SQ",
            "city": "SAYRE",
            "state": "PA",
            "postal_code": "188401625",
            "telephone_number": "570-888-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3344 CHAMBERS RD",
            "city": "HORSEHEADS",
            "state": "NY",
            "postal_code": "148451403",
            "telephone_number": "607-734-2264",
            "fax_number": "607-734-2932"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "254 E 1st St",
            "address_purpose": "LOCATION",
            "city": "Corning",
            "state": "NY",
            "postal_code": "148302925",
            "country_code": "US",
            "telephone_number": "607-937-5317",
            "fax_number": "607-937-6254",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROESSLER",
        "first_name": "ALAN",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2018-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "130308",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUSINESS TAX ID",
            "identifier": "161355553",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00372665",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Horseheads, NY

Sources for this page

Verify at the official NPI Registry.