Individual provider Active NPI

Robert Andre De Roziere Jr., FNP

  • Family Nurse Practitioner
  • Dayton, OH
National Provider Identifier
1396200523
Registry record updated Feb 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP024148 Issued in OH
Practice address
Maria Joseph Care Center
4780 Salem Avenue
Dayton, OH 45416
Phone
(937) 278-2692
NPI assigned
Feb 1, 2019
Sex
Male
Sole proprietor
No

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 and National Provider Directory roles.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kimberly S Neace MSN CNP LLC 3 clinicians

Practice addresses (Care Compare)

101 Mills PL
New Lebanon, OH 45345-1430
Phone (937) 603-4507

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
91.35
Improvement activities
40
Cost
84.59

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190218001298 OH Practitioner - Nurse Practitioner 0143568139 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
024148OHMDFamily Nurse Practitioner
APRN.CNP024148OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Geriatric Care Providers Inc CurrentSince May 15, 2024 Accepting new patients
Eaton Gardens Rehabilitation and Health Care LLC Past Accepting new patients

Locations

3195 Dayton Xenia Rd
#309
Dayton, OH 45434

Interoperability endpoints

  • Direct secure messaging: robert.deroziere@955045889703940.direct.elationemr.com

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 024148 OH
Family Nurse Practitioner 363LF0000X APRN.CNP024148 OH Primary

Addresses

NPPES NPI Registry

Primary practice location

Maria Joseph Care Center
4780 Salem Avenue
Dayton, OH 45416

Mailing address

1131 Tabor Ave
Dayton, OH 45420-1425
Phone (937) 818-6216

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 1, 2019.

{
    "created_epoch": "1548979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548979200000",
    "number": "1396200523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1131 TABOR AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454201425",
            "telephone_number": "937-818-6216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MARIA JOSEPH CARE CENTER",
            "address_2": "4780 SALEM AVENUE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "45416",
            "telephone_number": "937-278-2692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE ROZIERE",
        "first_name": "ROBERT",
        "middle_name": "ANDRE",
        "name_suffix": "Jr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-01",
        "last_updated": "2019-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "024148",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP024148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.