Individual provider Active NPI

Zsachlayne Roguska, PA-C

  • Physician Assistant
  • Cookeville, TN
National Provider Identifier
1568829984
Registry record updated May 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5427 Issued in TN
Practice address
105 S Willow Ave
Cookeville, TN 38501-4667
Phone
(931) 526-9518
Fax
(931) 372-0087
NPI assigned
Jan 15, 2016
Last updated
May 24, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5427 TN Primary
Intermediate Emergency Medical Technician 146M00000X P070358 NC
Athletic Trainer 2255A2300X AL3504 FL
Athletic Trainer 2255A2300X NC2405 NC

Addresses

Primary practice location

105 S Willow Ave
Cookeville, TN 38501-4667

Mailing address

1400 S Germantown Rd
Germantown, TN 38138-2205
Phone (901) 759-3100

Other identifiers 1

IdentifierTypeStateIssuer
Q081480MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230320002521 TN Practitioner - Physician Assistant 1850765538 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Tennessee, HSC, College of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Campbell Clinic, PCGroup PAC ID 9638082076, 229 clinicians

Practice addresses (Care Compare)

105 S Willow Ave
Cookeville, TN 38501-4667
Phone (931) 526-9518

1400 S Germantown Rd
Germantown, TN 38138-2205
Phone (901) 759-3100

317 W Spring St
Cookeville, TN 38501-7102
Phone (931) 526-9518

335 W Spring St
Cookeville, TN 38501-3125
Phone (931) 526-9518

35 Taylor Ave
Crossville, TN 38555-4526
Phone (931) 526-9518

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75.09 of 100Reported as group
Quality
50.47
Promoting interoperability
99
Improvement activities
40
Cost
67.33

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
P070358NCMDIntermediate Emergency Medical Technician
AL3504FLMDAthletic Trainer
NC2405NCMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Campbell Clinic, PC Physician Assistant CurrentSince Mar 1, 2023 Accepting new patients
Campbell Clinic PC CurrentSince Mar 1, 2023 Accepting new patients
Campbell Clinic Past Accepting new patients
CC Bpci PLC Past Accepting new patients

Locations

105 S Willow Ave
Cookeville, TN 38501
Phone (931) 372-7716

317 W Spring St
Cookeville, TN 38501
Phone (931) 520-9250

335 W Spring St
Cookeville, TN 38501
Phone (931) 303-0446

35 Taylor Ave
Crossville, TN 38555
Phone (865) 483-8478

1400 S Germantown Rd
Memphis, TN 38138
Phone (901) 759-3111

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1366/brand/1/csg/1/fhir/r4
  • Direct secure messaging: zsachlayne.roguska.1@1366.direct.athenahealth.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1452816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1568829984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 S GERMANTOWN RD",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381382205",
            "telephone_number": "901-759-3100",
            "fax_number": "833-464-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 S WILLOW AVE",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385014667",
            "telephone_number": "931-526-9518",
            "fax_number": "931-372-0087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGUSKA",
        "first_name": "ZSACHLAYNE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-15",
        "last_updated": "2023-05-24",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "5427",
            "primary": true
        },
        {
            "code": "146M00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Intermediate",
            "state": "NC",
            "license": "P070358",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL3504",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NC",
            "license": "NC2405",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q081480",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cookeville, TN

Sources for this page

Verify at the official NPI Registry.