Individual provider Active NPI

Michael Ramon Roessler, PA

  • Physician Assistant
  • Fort Liberty, NC
National Provider Identifier
1598538274
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1213790 Issued in TX
Practice address
2817 Reilly St
Fort Liberty, NC 28310-7324
Phone
(512) 517-0012
NPI assigned
Nov 3, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1213790 TX Primary

Addresses

Primary practice location

2817 Reilly St
Fort Liberty, NC 28310-7324

Mailing address

207 Camille CT
Pflugerville, TX 78660-2641
Phone (512) 517-0012

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20251108000416 NC Practitioner - Physician Assistant 8628568441 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Robeson Emergency Physicians PLLCGroup PAC ID 3870846934, 29 clinicians

Practice addresses (Care Compare)

300 W 27TH St
Lumberton, NC 28358-3075
Phone (910) 671-5000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1213790TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Robeson Emergency Physicians, PLLC CurrentSince Oct 1, 2025 Accepting new patients

Locations

300 W 27th St
Lumberton, NC 28358
Phone (910) 671-5000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1698969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1598538274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 CAMILLE CT",
            "city": "PFLUGERVILLE",
            "state": "TX",
            "postal_code": "786602641",
            "telephone_number": "512-517-0012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 REILLY ST",
            "city": "FORT LIBERTY",
            "state": "NC",
            "postal_code": "283107324",
            "telephone_number": "512-517-0012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROESSLER",
        "first_name": "MICHAEL",
        "middle_name": "RAMON",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-03",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "1213790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Liberty, NC

Sources for this page

Verify at the official NPI Registry.