Active NPI
Irene Erica Roge, D.P.M.
- Podiatrist
- Greenwood, IN
National Provider Identifier
1497762819
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 07001009A
- Practice address
- 1558 Victoria CT
Greenwood, IN 46143-7884 - Phone
- (317) 697-6536
- Fax
- (317) 859-2923
- NPI assigned
- Aug 1, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 07001009A | IN | Primary |
| Podiatrist | 213E00000X | IL |
Addresses
Primary practice location
1558 Victoria CT
Greenwood, IN 46143-7884
Mailing address
1558 Victoria CT
Greenwood, IN 46143-7884
Phone (317) 697-6536
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00276788 | Other | IL | RAILROAD MEDICARE |
| P00336058 | Other | IN | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 016-004849 | IL | MD | Podiatrist |
| 07001009A | IN | MD | Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Quality Podiatry Group, LTD | Podiatrist | Past | Accepting new patients |
| Nikola Ivancevic DPM PC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Foot Surgery Podiatrist
- Elmhurst, IL
- NPI 1013191287
-
- Podiatrist
- Skokie, IL
- NPI 1760585814
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1199664000000",
"number": "1497762819",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1558 VICTORIA CT",
"city": "GREENWOOD",
"state": "IN",
"postal_code": "461437884",
"telephone_number": "317-697-6536",
"fax_number": "317-859-2923"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1558 VICTORIA CT",
"city": "GREENWOOD",
"state": "IN",
"postal_code": "461437884",
"telephone_number": "317-697-6536",
"fax_number": "317-859-2923"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROGE",
"first_name": "IRENE",
"middle_name": "ERICA",
"name_prefix": "Dr.",
"credential": "D.P.M.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-01",
"last_updated": "2008-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "IN",
"license": "07001009A",
"primary": true
},
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "IL",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00276788",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00336058",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Greenwood, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.