NPIMap

Individual provider Active NPI

Michael L Roach, MD

  • Family Medicine Physician
  • Caldwell, ID
National Provider Identifier
1528004389
Registry record updated Aug 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M7815 Issued in ID
Practice address
712 Aviation Way
Caldwell, ID 83605-1154
Phone
(208) 302-7100
Fax
(208) 302-7155
NPI assigned
Jun 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD203385 OR
Family Medicine Physician 207Q00000X M7815 ID Primary

Addresses

Primary practice location

712 Aviation Way
Caldwell, ID 83605-1154

Mailing address

3340 E Goldstone Dr
Meridian, ID 83642-1026
Phone (208) 302-7500

Other practice location 1

1510 12th Ave Rd Ste 200
Nampa, ID 83686-6008
Phone (208) 302-6800

Other practice location 2

315 E Elm St Ste 200
Caldwell, ID 83605-4857
Phone (208) 302-7500

Other identifiers 1

IdentifierTypeStateIssuer
805573200MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, OR2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040517000731 ID Practitioner - Family Practice 3072503416 Reassigns benefits to 2 organizations
I20210520002694 OR Practitioner - Family Practice 3072503416 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
St. Louis College of Physicians and Surgeons, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1055 N Curtis Rd
Boise, ID 83706-1309
Phone (208) 367-2121

215 E Hawaii Ave
Nampa, ID 83686-6011

3025 W Cherry LN
Meridian, ID 83642-8531

712 Aviation Way
Caldwell, ID 83605-1154
Phone (208) 302-1035

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M7815IDMDFamily Medicine Physician
MD203385ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Alphonsus Regional Medical Center Inc Current Accepting new patients
Saint Alphonsus Medical Center- Ontario Inc CurrentSince Nov 22, 2021 Accepting new patients
Saint Alphonsus Medical Center Baker City, Inc Family Medicine CurrentSince Jun 1, 2021 Accepting new patients
Saint Alphonsus Medical Center Baker City, Inc CurrentSince Jun 1, 2021 Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Jan 18, 2010 Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Jan 18, 2010 Accepting new patients
Saint Alphonsus Medical Center- Ontario Inc CurrentSince Nov 22, 2021 Accepting new patients
Saint Alphonsus Regional Medical Center Inc Family Medicine Past Accepting new patients
Saint Alphonsus Physician Services Inc PastSince Dec 28, 2007 Accepting new patients

Locations

315 E Elm St
Ste 200
Caldwell, ID 83605
Phone (208) 302-7500

315 E Elm St
Caldwell, ID 83605
Phone (208) 402-0100

315 E Elm St
Ste 100
Caldwell, ID 83605
Phone (208) 302-7100

315 E Elm St
Ste 20
Caldwell, ID 83605

712 Aviation Way
Caldwell, ID 83605
Phone (208) 302-7100

910 NW 16th St
Ste 101
Fruitland, ID 83619
Phone (208) 452-8000

3025 W Cherry Ln
Meridian, ID 83642
Phone (208) 302-6400

3025 W Cherry Ln
Ste B
Meridian, ID 83642
Phone (208) 302-6400

3340 E Goldstone Dr
Meridian, ID 83642
Phone (208) 302-9342

1510 12th Ave Rd
Ste 200
Nampa, ID 83686
Phone (208) 302-0600

3325 Pocahontas Rd
Baker City, OR 97814
Phone (541) 523-1797

Interoperability endpoints

  • Direct secure messaging: mroach1564405@direct.trinity-health.org

Organizations & group practices 9

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 8

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": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756252800000",
    "number": "1528004389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 E GOLDSTONE DR",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836421026",
            "telephone_number": "208-302-7500",
            "fax_number": "208-302-7555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 AVIATION WAY",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836051154",
            "telephone_number": "208-302-7100",
            "fax_number": "208-302-7155"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1510 12th Ave Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Nampa",
            "state": "ID",
            "postal_code": "836866008",
            "country_code": "US",
            "telephone_number": "208-302-6800",
            "fax_number": "208-302-6855",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "315 E Elm St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Caldwell",
            "state": "ID",
            "postal_code": "836054857",
            "country_code": "US",
            "telephone_number": "208-302-7500",
            "fax_number": "208-302-7555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROACH",
        "first_name": "MICHAEL",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD203385",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M7815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805573200",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Caldwell, ID

Sources for this page

Verify at the official NPI Registry.