Jonathan D Roe, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

35916-20 Issued in WI

Practice address

3400 Deerfield Dr
Janesville, WI 53546-3557

Phone

(608) 314-3600

Fax

(608) 314-3601

NPI assigned

Dec 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in WI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jroe2224@direct.mhemail.org

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.

• Mercy Health System Corporation

  • Multi-Specialty Clinic/Center
  • Janesville, WI
  • NPI 1598718603
  Medicare reassignment NPD
• Mercy Health System Corporation

  • General Acute Care Hospital
  • Janesville, WI
  • NPI 1093768962
  NPD
• Mercy Health System Corporation

  • Critical Access Hospital
  • Lake Geneva, WI
  • NPI 1699728550
  NPD
• Mercy Health System Corporation

  • Prosthetic/Orthotic Supplier
  • Lake Geneva, WI
  • NPI 1710124698
  NPD (past)

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429142400000",
    "number": "1366507709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DEERFIELD DR",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535463557",
            "telephone_number": "608-314-3600",
            "fax_number": "608-314-3601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 DEERFIELD DR",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535463557",
            "telephone_number": "608-314-3600",
            "fax_number": "608-314-3601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROE",
        "first_name": "JONATHAN",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-26",
        "last_updated": "2015-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "35916-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32061100",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "347845572 1",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCYCARE INSURANCE",
            "identifier": "ROEJON",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rock County 51437 Board
• Rock Valley Community Programs, Inc.
• Rock Valley Radiology, SC
• John Christopher Rockwell, O.D.
• Ernesto Alonzo Rodriguez, CRNA
• Gayle A Rollmann, OTR
• Adriana Cristina Roman Soto, MD
• Paul Nicholas Romanelli, DDS
• Sam Paul Romano Jr., MSW LCSW
• Krystal Romero Valentin, MD

• Pediatrics Physician in Janesville, WI
• Providers in Janesville, WI by specialty
• Pediatrics Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.