Leslie Roub

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

MD019570E Issued in PA

Practice address

144 State St
Portland, ME 04101-3776

Phone

(207) 879-3000

NPI assigned

Dec 29, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Diagnostic Radiology

Education

University of Pittsburgh School of Medicine, 1976

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mount Nittany Medical Center Health Services IncGroup PAC ID 8426136797, 366 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Mount Nittany Medical Center Health Services Inc

  • Internal Medicine Physician
  • State College, PA
  • NPI 1598992554
  Medicare reassignment Care Compare group NPD
• Upmc Altoona Regional Health Services, Inc

  • Family Medicine Physician
  • Altoona, PA
  • NPI 1396724217
  Medicare reassignment NPD
• Tyrone Hospital

  • Critical Access Hospital
  • Tyrone, PA
  • NPI 1659472447
  Medicare reassignment
• Tyrone Hospital

  • Critical Access Hospital
  • Tyrone, PA
  • NPI 1518130731
  NPD
• Upmc Altoona Regional Health Services, Inc

  • Internal Medicine Physician
  • Altoona, PA
  • NPI 1639158488

  Diagnostic Radiology

  NPD
• Hancock County Radiology Consultants PA

  • Diagnostic Radiology Physician
  • Bar Harbor, ME
  • NPI 1831176627
  NPD (past)
• Northern Radiological Associates

  • Specialist
  • Presque Isle, ME
  • NPI 1386677169
  NPD (past)
• South Coast Radiology, P.a.

  • Diagnostic Radiology Physician
  • York, ME
  • NPI 1326024365
  NPD (past)
• Frank Olney & Rudy Nicolas PTRS

  • Specialist
  • Altoona, PA
  • NPI 1417918756

  Diagnostic Radiology

  NPD (past)

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

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1396722401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1849",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042411849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 STATE ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041013776",
            "telephone_number": "207-879-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 E Park Ave",
            "address_purpose": "LOCATION",
            "city": "State College",
            "state": "PA",
            "postal_code": "168036701",
            "country_code": "US",
            "telephone_number": "814-231-7000 x6764",
            "fax_number": "814-231-7098",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1700 Old Gatesburg Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "State College",
            "state": "PA",
            "postal_code": "168032276",
            "country_code": "US",
            "telephone_number": "814-278-3280",
            "fax_number": "814-231-7098",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROUB",
        "first_name": "LESLIE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-29",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD019570E",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "ME",
            "license": "010222",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "upmchospitals@upmcdirect.com",
            "affiliation": "Y",
            "affiliationName": "UPMC",
            "address_1": "600 Grant St",
            "address_2": "Floor 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Charles J. Roth, PA-C
• Debra A Rothenberg, M.D.
• Rute S Rothwell, MD
• Stacey Anne Rotta, M.D.
• Bruce Glenn Rottmann, MD
• James H Rough, PSYD
• Cindy M. Rounds, LCPC
• Margarett J Rounsavall
• Tyla Rouse, PHARMD
• Erin Adams Rowan, OCCUPATIONAL THERAPI

• Diagnostic Radiology Physician in Portland, ME
• Providers in Portland, ME by specialty
• Diagnostic Radiology Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; 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.