NPIMap

Individual provider Active NPI

David J Roach, M.D.

  • Emergency Medicine Physician
  • Louisville, KY
National Provider Identifier
1457795734
Registry record updated Aug 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
TP225 Issued in KY
Practice address
100 Mallard Creek Rd
Suite 406
Louisville, KY 40207-5166
Phone
(502) 895-4607
Fax
(502) 895-4586
NPI assigned
Apr 17, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X TP225 KY Primary

Addresses

Primary practice location

100 Mallard Creek Rd
Suite 406
Louisville, KY 40207-5166

Mailing address

100 Mallard Creek Rd
Suite 406
Louisville, KY 40207-5166
Phone (502) 895-4607

Other identifiers 1

IdentifierTypeStateIssuer
7100310450MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150713001910 KY Practitioner - Emergency Medicine 8628381134 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Louisville School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Medical Associates IncGroup PAC ID 7012811284, 1,368 clinicians

Practice addresses (Care Compare)

4123 Dutchmans LN
Suite 507
Louisville, KY 40207-4730
Phone (502) 259-3250

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.11 of 100Reported as group
Quality
63.34
Promoting interoperability
100
Improvement activities
40
Cost
73.68

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
TP225KYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Associates, Inc. Current Accepting new patients
Community Medical Associates, Inc. CurrentSince Aug 23, 2023 Accepting new patients
Community Medical Associates, Inc. CurrentSince Aug 23, 2023 Accepting new patients

Locations

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

1 Audubon Plaza Dr
Louisville, KY 40217
Phone (502) 634-6767

4123 Dutchmans Ln
Ste 507
Louisville, KY 40207
Phone (502) 259-3250

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1366156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472083200000",
    "number": "1457795734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MALLARD CREEK RD",
            "address_2": "SUITE 406",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402075166",
            "telephone_number": "502-895-4607",
            "fax_number": "502-895-4586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MALLARD CREEK RD",
            "address_2": "SUITE 406",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402075166",
            "telephone_number": "502-895-4607",
            "fax_number": "502-895-4586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROACH",
        "first_name": "DAVID",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-17",
        "last_updated": "2016-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "TP225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100310450",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.