Individual provider Active NPI

Richard J Roethel, MD

  • Emergency Medicine Physician
  • Texas City, TX
National Provider Identifier
1366412181
Registry record updated Feb 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
J1374 Issued in TX
Practice address
6801 Emmett F Lowry Expy
Texas City, TX 77591-2500
Phone
(409) 938-5000
Fax
(409) 938-5001
NPI assigned
Jan 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X J1374 TX Primary

Addresses

Primary practice location

6801 Emmett F Lowry Expy
Texas City, TX 77591-2500

Mailing address

3910 Travis Lake CT
Pearland, TX 77581-4783
Phone (281) 485-1896

Other identifiers 1

IdentifierTypeStateIssuer
89514ZOtherTXBC/BS PROVIDER NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20071106000726 TX Practitioner - Emergency MedicinePractitioner - Internal Medicine 6305933482 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
J1374TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Integrative Emergency Services Physician Group-Houston PLLC Emergency Medicine CurrentSince Nov 1, 2019 Accepting new patients
Bay Area Emergency Partners Emergency Medicine CurrentSince Jan 26, 2013 Accepting new patients
Beltway 8 Emergency Physicians Emergency Medicine Past Accepting new patients
Harris Emergency Medicine Associates PA Emergency Medicine Past Accepting new patients
Sweet Water Emergency Physicians PLLC Emergency Medicine Past Accepting new patients

Locations

4835 Lyndon B Johnson Fwy
Ste 900
Dallas, TX 75244
Phone (469) 340-1366

540 Interstate 45 S
Ste E
Huntsville, TX 77340
Phone (936) 755-8288

5161 E Sam Houston Pkwy S
Pasadena, TX 77505
Phone (281) 810-9326

4600 E Sam Houston Pkwy S
Pasadena, TX 77505
Phone (713) 853-9302

11713 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 793-4600

Organizations & group practices 5

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": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203552000000",
    "number": "1366412181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3910 TRAVIS LAKE CT",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775814783",
            "telephone_number": "281-485-1896",
            "fax_number": "281-485-1896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 EMMETT F LOWRY EXPY",
            "city": "TEXAS CITY",
            "state": "TX",
            "postal_code": "775912500",
            "telephone_number": "409-938-5000",
            "fax_number": "409-938-5001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROETHEL",
        "first_name": "RICHARD",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-24",
        "last_updated": "2008-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "J1374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS PROVIDER NUMBER",
            "identifier": "89514Z",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Texas City, TX

Sources for this page

Verify at the official NPI Registry.