Individual provider Active NPI

Mindi M Roeser, MD

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1487688453
Registry record updated Apr 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD048483L Issued in PA
Practice address
800 Spruce Street
Pine 1 West
Philadelphia, PA 19107-6130
Phone
(215) 829-7817
Fax
(215) 829-7129
NPI assigned
Jul 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD048483L PA
Internal Medicine Physician 207R00000X MD048483L PA Primary

Addresses

Primary practice location

800 Spruce Street
Pine 1 West
Philadelphia, PA 19107-6130

Mailing address

800 Spruce Street
Pine 1 West
Philadelphia, PA 19107-6130
Phone (215) 829-7817

Other identifiers 1

IdentifierTypeStateIssuer
001411940MedicaidPA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20100512000371 PA Practitioner - HospitalistPractitioner - Internal MedicinePractitioner - Hospice/Palliative Care 0042348096 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Hospice/Palliative Care
Education
University of Maryland School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

230 W Washington SQ
Palliative Care Pah
Philadelphia, PA 19106-3585
Phone (215) 829-3985

Hospital & facility affiliations

  • Pennsylvania Hospital Hospital, Philadelphia, PA, CCN 390226
  • Penn Presbyterian Medical Center Hospital, Philadelphia, PA, CCN 390223
  • Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Care Associates of the University of Pennsylvania Health Internal Medicine Current Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Syst Internal Medicine CurrentSince Jul 1, 2001 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince Jul 1, 2001 Accepting new patients
The Pennsylvania Hospital of the University of Pennsylvania Health Sys Past Accepting new patients
Clinical Specialty Associates Past Accepting new patients

Locations

800 Spruce St
#1W
Philadelphia, PA 19107
Phone (215) 829-7817

230 W Washington Sq
Philadelphia, PA 19106
Phone (215) 829-5064

800 Spruce St
Fl 1
Philadelphia, PA 19107
Phone (215) 829-5873

230 W Washington Sq
Ste 102
Philadelphia, PA 19106
Phone (215) 829-3985

250 King of Prussia Rd
Fl 4
Radnor, PA 19087
Phone (610) 902-1720

800 Spruce St
William Penn Annex West, PA 19107
Phone (215) 829-3867

800 Spruce St
#1
William Penn Annex West, PA 19107
Phone (215) 829-2222

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

Organizations & group practices 5

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 4

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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333324800000",
    "number": "1487688453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 SPRUCE STREET",
            "address_2": "PINE 1 WEST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191076130",
            "telephone_number": "215-829-7817",
            "fax_number": "251-829-7129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 SPRUCE STREET",
            "address_2": "PINE 1 WEST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191076130",
            "telephone_number": "215-829-7817",
            "fax_number": "215-829-7129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROESER",
        "first_name": "MINDI",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2012-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD048483L",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD048483L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001411940",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.