Individual provider Active NPI

Derrick Andrew Roskopf, PHARMD

  • Pharmacist
  • Waukesha, WI
National Provider Identifier
1376261966
Registry record updated Aug 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
21421-40 Issued in WI
Practice address
230 Madison St
Waukesha, WI 53188-5148
Phone
(262) 542-9935
NPI assigned
Aug 18, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 21421-40 WI Primary

Addresses

Primary practice location

230 Madison St
Waukesha, WI 53188-5148

Mailing address

9075 W Sura LN Unit 302
Greenfield, WI 53228-3550
Phone (414) 322-3378

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
21421-40WIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co CurrentSince Jun 16, 2024 Accepting new patients
Walgreen Co PastSince Aug 28, 2022 Accepting new patients

Locations

230 Madison St
Waukesha, WI 53188
Phone (262) 542-9935

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": "1660780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660780800000",
    "number": "1376261966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9075 W SURA LN UNIT 302",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532283550",
            "telephone_number": "414-322-3378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 MADISON ST",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531885148",
            "telephone_number": "262-542-9935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSKOPF",
        "first_name": "DERRICK",
        "middle_name": "ANDREW",
        "name_prefix": "Mr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-18",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "21421-40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.