Individual provider Active NPI

Steven Forest Roark, MD

  • Interventional Cardiology Physician
  • Gainesville, FL
National Provider Identifier
1386610483
Registry record updated Feb 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
ME38483 Issued in FL
Practice address
4645 NW 8TH Ave
Gainesville, FL 32605-4524
Phone
(352) 264-2500
Fax
(352) 331-9095
NPI assigned
Feb 27, 2006
Last updated
Feb 12, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X ME38483 FL Primary
Cardiovascular Disease Physician 207RC0000X ME38483 FL

Addresses

Primary practice location

4645 NW 8TH Ave
Gainesville, FL 32605-4524

Mailing address

4645 NW 8TH Ave
Gainesville, FL 32605-4524
Phone (352) 264-2500

Other identifiers 1

IdentifierTypeStateIssuer
044166000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20071003000442 FL Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 6709971914 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiology Associates of Gainesville Cardiovascular Disease Current Accepting new patients
Interventional Cardiologists of Gainesville, PA Cardiovascular Disease CurrentSince Jan 16, 2012 Accepting new patients
Cardiology Associates of Gainesville Cardiovascular Disease Past Accepting new patients

Locations

4645 NW 8th Ave
Ste 20
Gainesville, FL 32605
Phone (352) 375-1212

1151 NW 64th Ter
Gainesville, FL 32605
Phone (352) 331-8570

4645 NW 8th Ave
Gainesville, FL 32605
Phone (352) 264-2500

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392163200000",
    "number": "1386610483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4645 NW 8TH AVE",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054524",
            "telephone_number": "352-264-2500",
            "fax_number": "352-331-9095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4645 NW 8TH AVE",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054524",
            "telephone_number": "352-264-2500",
            "fax_number": "352-331-9095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROARK",
        "first_name": "STEVEN",
        "middle_name": "FOREST",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2014-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "FL",
            "license": "ME38483",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME38483",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "044166000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.