Individual provider Active NPI

Eric Roll

  • Psychiatry Physician
  • Salem, MA
National Provider Identifier
1568824134
Registry record updated Mar 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
281877 Issued in MA
Practice address
55 Highland Ave Ste 201
Salem, MA 01970-2100
Phone
(978) 825-6620
Fax
(978) 825-6622
NPI assigned
Mar 23, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 281877 MA Primary

Addresses

Primary practice location

55 Highland Ave Ste 201
Salem, MA 01970-2100

Mailing address

55 Highland Ave Ste 201
Salem, MA 01970-2100
Phone (978) 825-6620

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20210608002530 MA Practitioner - Psychiatry 1759676877 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Wake Forest University School of Medicine, 2016
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
North Shore Medical Center, Inc.Group PAC ID 3274427570, 44 clinicians

Practice addresses (Care Compare)

55 Highland Ave
Suite 201
Salem, MA 01970-2100
Phone (978) 825-6620

81 Highland Ave
Salem, MA 01970-2714
Phone (978) 354-2551

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
281877MAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mass General Brigham Medical Group Northern Massachusetts Inc CurrentSince Jun 16, 2023 Accepting new patients
North Shore Medical Center, Inc. CurrentSince Aug 14, 2023 Accepting new patients
North Shore Medical Center, Inc. CurrentSince Aug 14, 2023 Accepting new patients
Emerson Practice Associates, Inc. CurrentSince Jul 6, 2021 Accepting new patients
Commonwealth Pathology Partners, P.C. Current Accepting new patients
NSPG Billing LLC Past Accepting new patients

Locations

133 Ornac
Concord, MA 01742
Phone (978) 287-3000

1 Hutchinson Dr
Danvers, MA 01923
Phone (978) 739-6950

480 Lynnfield St
Lynn, MA 01904
Phone (781) 581-3280

81 Highland Ave
Salem, MA 01970
Phone (978) 354-4009

55 Highland Ave
Ste 201
Salem, MA 01970
Phone (978) 745-6601

9 Northeastern Blvd
Ste 400
Salem, NH 03079

Interoperability endpoints

  • Direct secure messaging: roll.eric.nsmc@direct.partners.masshiway.net

Organizations & group practices 6

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 1

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": "1458691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1568824134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 HIGHLAND AVE STE 201",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019702100",
            "telephone_number": "978-825-6620",
            "fax_number": "978-825-6622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 HIGHLAND AVE STE 201",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019702100",
            "telephone_number": "978-825-6620",
            "fax_number": "978-825-6622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLL",
        "first_name": "ERIC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-23",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "281877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, MA

Sources for this page

Verify at the official NPI Registry.