Individual provider Active NPI

Joshua Sheridan Roark, M.D.

  • Interventional Cardiology Physician
  • Portland, OR
National Provider Identifier
1619389368
Registry record updated Aug 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
MD204242 Issued in OR
Practice address
10000 SE Main St Ste 60
Portland, OR 97216-2474
Phone
(503) 257-0959
Fax
(503) 256-7757
NPI assigned
May 29, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 201232 NC
Hospitalist Physician 208M00000X 2017-01347 NC
Interventional Cardiology Physician 207RI0011X MD204242 OR Primary

Addresses

Primary practice location

10000 SE Main St Ste 60
Portland, OR 97216-2474

Mailing address

10000 SE Main St Ste 60
Portland, OR 97216-2474
Phone (503) 257-0959

Other practice location 1

3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013
Phone (336) 718-7080

Other practice location 2

101 Manning Dr
Chapel Hill, NC 27514-4220
Phone (919) 966-7706

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jroark531691@direct.novanthealth.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210806000578 OR Practitioner - Interventional Cardiology 7315163870 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Cardiology
Education
University of Mississippi School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Portland Adventist Medical CenterGroup PAC ID 3274908819, 273 clinicians

Practice addresses (Care Compare)

10000 SE Main St
Suite 60
Portland, OR 97216-2474
Phone (503) 257-0959

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92 of 100Reported as group
Quality
84.7
Promoting interoperability
100
Improvement activities
40
Cost
79.21

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting48
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD204242ORMDInterventional Cardiology Physician
2017-01347NCMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Columbia Medical Center Internal Medicine CurrentSince Apr 1, 2025 Accepting new patients
Portland Adventist Medical Center CurrentSince Aug 16, 2021 Accepting new patients
Portland Adventist Medical Center Internal Medicine CurrentSince Aug 26, 2023 Accepting new patients
Portland Adventist Medical Center Internal Medicine CurrentSince Aug 16, 2021 Accepting new patients
Portland Adventist Medical Center CurrentSince Aug 26, 2023 Accepting new patients
Mid-Columbia Medical Center CurrentSince Apr 1, 2025 Accepting new patients
Mid-Columbia Medical Center Past Accepting new patients
Portland Adventist Medical Center Past Accepting new patients

Locations

10151 SE Sunnyside Rd
Ste 100
Clackamas, OR 97015
Phone (503) 659-0880

14450 SE Royer Rd
Damascus, OR 97089
Phone (503) 658-5521

2700 SE Stratus Ave
McMinnville, OR 97128
Phone (503) 435-1200

2700 SE Stratus Ave
Unit 406
McMinnville, OR 97128
Phone (503) 435-1200

10000 SE Main St
Ste 60A
Portland, OR 97216
Phone (503) 257-0959

10000 SE Main St
Ste 60
Portland, OR 97216
Phone (503) 257-0959

1805 E 19th St
The Dalles, OR 97058
Phone (541) 296-2201

1700 E 19th St
The Dalles, OR 97058
Phone (541) 296-7251

551 Lone Pine Blvd
The Dalles, OR 97058
Phone (541) 296-7202

Interoperability endpoints

  • Direct secure messaging: jroark154760@direct.ohsu.edu

Organizations & group practices 8

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 7

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": "1401321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629676800000",
    "number": "1619389368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10000 SE MAIN ST STE 60",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162474",
            "telephone_number": "503-257-0959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 SE MAIN ST STE 60",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162474",
            "telephone_number": "503-257-0959",
            "fax_number": "503-256-7757"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3333 Silas Creek Pkwy",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271033013",
            "country_code": "US",
            "telephone_number": "336-718-7080",
            "fax_number": "336-718-9622",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 Manning Dr",
            "address_purpose": "LOCATION",
            "city": "Chapel Hill",
            "state": "NC",
            "postal_code": "275144220",
            "country_code": "US",
            "telephone_number": "919-966-7706",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROARK",
        "first_name": "JOSHUA",
        "middle_name": "SHERIDAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-29",
        "last_updated": "2021-08-23",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "201232",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NC",
            "license": "2017-01347",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "OR",
            "license": "MD204242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jroark531691@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "101 Manning Dr",
            "city": "Chapel Hill",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275144220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.