Individual provider Active NPI

Austin Jeffrey Roach, DNP, CRNA

  • Certified Registered Nurse Anesthetist
  • Platteville, WI
National Provider Identifier
1457245276
Registry record updated Jul 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
17046-33 Issued in WI
Practice address
1400 Eastside Rd
Platteville, WI 53818-9800
Phone
(608) 348-2331
NPI assigned
Jun 5, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 17046-33 WI Primary

Addresses

Primary practice location

1400 Eastside Rd
Platteville, WI 53818-9800

Mailing address

1400 Eastside Rd
Platteville, WI 53818-9800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250729000130 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 7113434853 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Health Center IncGroup PAC ID 3072427772, 110 clinicians

Practice addresses (Care Compare)

1400 Eastside Rd
Platteville, WI 53818-9800
Phone 60834823312263

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17046-33WIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Health Center, Inc CurrentSince Dec 1, 2025 Accepting new patients
Southwest Health Center, Inc. CurrentSince Jul 8, 2025 Accepting new patients
Southwest Health Center, Inc. CurrentSince Jul 8, 2025 Accepting new patients

Locations

1400 Eastside Rd
Platteville, WI 53818
Phone (608) 342-4712

Interoperability endpoints

  • Direct secure messaging: aroach552897@direct-ehr-ssmhc.com

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1749081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752710400000",
    "number": "1457245276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 EASTSIDE RD",
            "city": "PLATTEVILLE",
            "state": "WI",
            "postal_code": "538189800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 EASTSIDE RD",
            "city": "PLATTEVILLE",
            "state": "WI",
            "postal_code": "538189800",
            "telephone_number": "608-348-2331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROACH",
        "first_name": "AUSTIN",
        "middle_name": "JEFFREY",
        "credential": "DNP, CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-05",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "17046-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Platteville, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.