Travis Roeder, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

318 Richland West Cir
Waco, TX 76712-7911

Phone

(254) 776-8008

NPI assigned

Mar 13, 2023

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

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Waco Functional Medicine, PAGroup PAC ID 0244416162, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension Providence Hospital, Waco, TX, CCN 450042

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DCFICA/Endpoint/DCFICA

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.

• Waco Functional Medicine, PA

  • Family Medicine Physician
  • Waco, TX
  • NPI 1093016826
  Medicare reassignment Care Compare group
• GTG Enterprises, LLC

  • Family Medicine Physician
  • Waco, TX
  • NPI 1588240782
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ascension Providence

  • General Acute Care Hospital
  • Waco, TX
  • NPI 1093708679
  Care Compare affiliation

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

{
    "created_epoch": "1678665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678665600000",
    "number": "1396446829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5106 LAKE PLACID PL",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767102924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 RICHLAND WEST CIR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767127911",
            "telephone_number": "254-776-8008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROEDER",
        "first_name": "TRAVIS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-13",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fabiola Rodriguez, SLP-ASSISTANT
• Kathryn Lavonne Rodriguez
• Laura Rodriguez
• Lydia Rodriguez, OT
• Ryan Rodriguez, PHARMD
• Brian Keith Roemer, CPHT
• Cameron Rogers
• Christopher Charles Rogers, DPT
• Dana Rogers, CRNA
• Edward Rogers, PSY.D

• Medical Physician Assistant in Waco, TX
• Providers in Waco, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.