Susan Light Roewe, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

64848-20 Issued in WI

Practice address

1690 Elm St Ste 300
Dubuque, IA 52001-3679

Phone

(563) 690-2850

Fax

(563) 557-8488

NPI assigned

Mar 31, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Susan K Light Former name

Medicare fee-for-service enrollment

Enrolled in IA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sroewe1077479@direct.unitypoint.org

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.

• Iowa Physicians Clinic Medical Foundation

  • General Practice Physician
  • West Des Moines, IA
  • NPI 1366425274

  Pediatrics

  Medicare reassignment NPD
• St Luke'S Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  NPD

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

{
    "created_epoch": "1396224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1417375221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1690 ELM ST STE 300",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520013679",
            "telephone_number": "636-902-8505",
            "fax_number": "635-578-4885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1690 ELM ST STE 300",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520013679",
            "telephone_number": "563-690-2850",
            "fax_number": "563-557-8488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROEWE",
        "first_name": "SUSAN",
        "middle_name": "LIGHT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-31",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "64848-20",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "MD-46764",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "LIGHT",
            "middle_name": "K",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rocky Mountain Holdings, LLC
• Alberto Rodriguez Hernandez, M.D.
• Stephanie Rodriguez
• Jaclyn Rita Mae Roeder, PT, DPT
• Raymond Farlow Roewe Jr.
• Rachel Elizabeth Rokser, PA-C
• Angela Jeanne Roling, NP
• Benjamin Michael Roling, M.D.
• Emily A Roling, ARNP
• Neal A Rolwes, D.C.

• Pediatrics Physician in Dubuque, IA
• Providers in Dubuque, IA by specialty
• Pediatrics Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.