NPIMap

Individual provider Active NPI

Kevin S Roof, M.D.

  • Radiation Oncology Physician
  • Mooresville, NC
National Provider Identifier
1528027547
Registry record updated Nov 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
200400407 Issued in NC
Practice address
170 Medical Park Rd
Suite 100
Mooresville, NC 28117-8540
Phone
(704) 235-2599
Fax
(704) 333-3397
NPI assigned
Mar 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 200400407 NC Primary
Radiation Oncology Physician 2085R0001X 26685 SC

Addresses

Primary practice location

170 Medical Park Rd
Suite 100
Mooresville, NC 28117-8540

Mailing address

200 Queens Rd
Suite 400
Charlotte, NC 28204-3253
Phone (704) 333-7376

Other identifiers 7

IdentifierTypeStateIssuer
136TKOtherNCBLUE CROSS
D5200OtherMEDCOST
804283OtherPARTNERS
89136TKMedicaidNC
N07004MedicaidSC
2474226OtherUNITED HEALTHCARE
2862751OtherCIGNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 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
I20040624000392 NC Practitioner - Radiation Oncology 4789669573 Reassigns benefits to 2 organizations
I20060504000334 SC Practitioner - Radiation Oncology 4789669573 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
University of North Carolina at Chapel Hill School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southeast Radiation Oncology Group, P.a.Group PAC ID 1254233950, 52 clinicians

Practice addresses (Care Compare)

200 Hawthorne LN
Charlotte, NC 28204-2515
Phone (704) 333-7376

200 Queens Rd
Charlotte, NC 28204-3264
Phone (704) 333-7376

Hospital & facility affiliations

  • Novant Health Huntersville Medical Center Hospital, Huntersville, NC, CCN 340183
  • Novant Health Presbyterian Medical Center Hospital, Charlotte, NC, CCN 340053
  • Carolinas Medical Center/Behav Health Hospital, Charlotte, NC, CCN 340113

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Radiation Oncology Group, P.a. Radiation Oncology CurrentSince Jul 1, 2004 Accepting new patients
Piedmont Carolinas Radiation Therapy LLC Current Accepting new patients
Piedmont Carolinas Radiation Therapy LLC CurrentSince Jan 1, 2006 Accepting new patients
Radiation Oncology Centers of the Carolinas, Inc. Radiation Oncology CurrentSince Jun 1, 2006 Accepting new patients

Locations

200 Hawthorne Ln
Charlotte, NC 28204
Phone (704) 377-2424

125 Queens Rd
Ste 150
Charlotte, NC 28204
Phone (980) 302-6144

200 Queens Rd
Ste 400
Charlotte, NC 28204
Phone (704) 765-2578

10030 Gilead Rd
Ste B120
Huntersville, NC 28078
Phone (704) 316-6630

1400 Matthews Township Pkwy
Matthews, NC 28105
Phone (704) 845-8800

170 Medical Park Rd
Ste 100
Mooresville, NC 28117
Phone (704) 235-2580

228 Herlong Ave S
Rock Hill, SC 29732
Phone (803) 366-5186

Interoperability endpoints

  • Direct secure messaging: kroof137015@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 4

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 11

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": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352851200000",
    "number": "1528027547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 QUEENS RD",
            "address_2": "SUITE 400",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043253",
            "telephone_number": "704-333-7376",
            "fax_number": "704-333-3397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 MEDICAL PARK RD",
            "address_2": "SUITE 100",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281178540",
            "telephone_number": "704-235-2599",
            "fax_number": "704-333-3397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROOF",
        "first_name": "KEVIN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-20",
        "last_updated": "2012-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NC",
            "license": "200400407",
            "primary": true
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "SC",
            "license": "26685",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "136TK",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "D5200",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS",
            "identifier": "804283",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89136TK",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N07004",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2474226",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2862751",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

Verify at the official NPI Registry.