Individual provider Active NPI

Paul Sebastian Roettges, MD

  • Adult Reconstructive Orthopaedic Surgery Physician
  • St Augustine, FL
National Provider Identifier
1609214246
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X
License
ME134760 Issued in FL
Practice address
45 Groover Loop Ste 201
St Augustine, FL 32086-6586
Phone
(904) 634-0640
Fax
(904) 634-0203
NPI assigned
Jun 5, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X R73929 AZ
Orthopaedic Surgery Physician 207X00000X ME134760 FL
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X ME134760 FL Primary

Addresses

Primary practice location

45 Groover Loop Ste 201
St Augustine, FL 32086-6586

Mailing address

6800 Southpoint Pkwy Ste 300
Jacksonville, FL 32216-8203
Phone (904) 634-0640

Other practice location 1

216 Southpark Cir E Ste 216
St Augustine, FL 32086-5135
Phone (904) 634-0640

Other practice location 2

3055 County Road 210 W Ste 110
St Johns, FL 32259-7001
Phone (904) 634-0640

Other practice location 3

1690 US Highway 1 S Ste F
St Augustine, FL 32084-6024
Phone (904) 634-0640

Other identifiers 1

IdentifierTypeStateIssuer
122407200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20180723001117 FL Practitioner - Orthopedic Surgery 4789905548 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Loyola University of Chicago, Stritch School of Medicine, 2013
Medicare assignment
May accept Medicare assignment
Group practices
Lake Area Physical Therapy Inc.Group PAC ID 3678604840, 372 clinicians

Practice addresses (Care Compare)

10475 Centurion Pkwy N
Suite 220
Jacksonville, FL 32256-5004
Phone (904) 634-0640

PO Box
Suite 1099
Melrose, FL 32666-1099

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.75 of 100Reported as group
Quality
88.19
Promoting interoperability
100
Improvement activities
40
Cost
80.96

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement109
Knee replacement174

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Orthopedic Specialists, LLC Orthopaedic Surgery CurrentSince Feb 10, 2022 Accepting new patients
Southeast Orthopedic Specialists, LLC Orthopaedic Surgery CurrentSince Feb 10, 2022 Accepting new patients
Center for Orthopedic Research and Education, LLC Orthopaedic Surgery Past Accepting new patients

Locations

6800 Southpoint Pkwy
Ste 300
Jacksonville, FL 32216

10475 Centurion Pkwy N
Ste 220
Jacksonville, FL 32256
Phone 9046340640 ext. 1014

10475 Centurion Pkwy N
Ste 200
Jacksonville, FL 32256

216 Southpark Cir E
Ste 216
St Augustine, FL 32086
Phone (904) 634-0203

216 Southpark Cir E
#216
St Augustine, FL 32086

45 Groover Loop
Unit 201
St Augustine, FL 32086
Phone (904) 634-0604

1690 US Highway 1 S
Ste F
St Augustine Beach, FL 32084
Phone (904) 634-0460

3055 County Road 210 W
Ste 110
St Johns, FL 32259
Phone (904) 634-0203

Interoperability endpoints

  • Direct secure messaging: paul.roettges.1@22724.direct.athenahealth.com
  • Direct secure messaging: proettges742580@direct.shands.ufl.edu

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 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": "1370390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1609214246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 SOUTHPOINT PKWY STE 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168203",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 GROOVER LOOP STE 201",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320866586",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "216 Southpark Cir E Ste 216",
            "address_purpose": "LOCATION",
            "city": "St Augustine",
            "state": "FL",
            "postal_code": "320865135",
            "country_code": "US",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0202",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3055 County Road 210 W Ste 110",
            "address_purpose": "LOCATION",
            "city": "St Johns",
            "state": "FL",
            "postal_code": "322597001",
            "country_code": "US",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1690 US Highway 1 S Ste F",
            "address_purpose": "LOCATION",
            "city": "St Augustine",
            "state": "FL",
            "postal_code": "320846024",
            "country_code": "US",
            "telephone_number": "904-634-0640",
            "fax_number": "904-634-0203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROETTGES",
        "first_name": "PAUL",
        "middle_name": "SEBASTIAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-05",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AZ",
            "license": "R73929",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "ME134760",
            "primary": false
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "FL",
            "license": "ME134760",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122407200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.