Individual provider Active NPI

Daeyoung D Roh, MD

  • Hospitalist Physician
  • Centennial, CO
National Provider Identifier
1619920675
Registry record updated Oct 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
G62251 Issued in CA
Practice address
15492 E Prentice Dr
Centennial, CO 80015-4267
Phone
(817) 296-9180
Fax
(817) 421-6252
NPI assigned
May 18, 2006
Last updated
Oct 19, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X DR.0051910 CO
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X G62251 CA
Internal Medicine Physician 207R00000X M3075 TX
Nephrology Physician 207RN0300X M3075 TX
Hospitalist Physician 208M00000X G62251 CA Primary

Addresses

Primary practice location

15492 E Prentice Dr
Centennial, CO 80015-4267

Mailing address

15492 E Prentice Dr
Centennial, CO 80015-4267
Phone (817) 296-9180

Other identifiers 6

IdentifierTypeStateIssuer
179849805MedicaidTX
179849802MedicaidTX
179849803MedicaidTX
179849801MedicaidTX
8S5106OtherTXBCBS
63503514OtherCOMEDICAID

Other names 1

  • David Roh Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130413000080 CO Practitioner - Internal Medicine 6103893524 Reassigns benefits to 2 organizations
I20140815002370 CA Practitioner - Internal Medicine 6103893524 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0051910COMDInternal Medicine Physician
G62251CAMDHospitalist Physician
62251CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
United Regional Health Care System Inc Multi-Specialty Current Accepting new patients
Galen Inpatient Physicians PC Multi-Specialty CurrentSince Sep 23, 2022 Accepting new patients
Galen Inpatient Physicians PC Multi-Specialty CurrentSince Sep 23, 2022 Accepting new patients
Colorado Hospitalist Services, PLLC Multi-Specialty CurrentSince Dec 29, 2015 Accepting new patients
Inpatient Services, PC Multi-Specialty CurrentSince Jan 25, 2013 Accepting new patients
Colorado Hospitalist Services, PLLC Multi-Specialty CurrentSince Dec 29, 2015 Accepting new patients
Galen Inpatient Physicians, PC Multi-Specialty Current Accepting new patients
Inpatient Services, PC Multi-Specialty CurrentSince Jan 25, 2013 Accepting new patients
Petrel Emergency Physicians, a Medical Corporation Multi-Specialty PastSince Sep 28, 2015 Accepting new patients
Texas Health Physicians Group Past Accepting new patients
Nephrology Associates Medical Group Inc Multi-Specialty Past Accepting new patients
Physicians and Allied Health Professionals Group, PA Multi-Specialty Past Accepting new patients

Locations

700 River Dr
Fort Bragg, CA 95437
Phone (707) 961-1234

115 Mall Dr
Hanford, CA 93230
Phone (559) 537-0550

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

869 N Cherry St
Tulare, CA 93274
Phone (559) 326-2800

501 E Hampden Ave
Englewood, CO 80113
Phone (303) 788-5300

8300 W 38th Ave
Wheat Ridge, CO 80033
Phone (303) 425-2015

Interoperability endpoints

  • Direct secure messaging: droh14594@unitedregional.medalliesdirect.net
  • FHIR API: https://epicproxy.et1096.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • FHIR API: https://epicproxy.et1096.epichosted.com/FHIRProxy/api/fhir/r4/

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666137600000",
    "number": "1619920675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15492 E PRENTICE DR",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "800154267",
            "telephone_number": "817-296-9180",
            "fax_number": "817-421-6252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15492 E PRENTICE DR",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "800154267",
            "telephone_number": "817-296-9180",
            "fax_number": "817-421-6252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROH",
        "first_name": "DAEYOUNG",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "DR.0051910",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G62251",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M3075",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "M3075",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "G62251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "179849805",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "179849802",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "179849803",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "179849801",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8S5106",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "63503514",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAVID",
            "last_name": "ROH",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Centennial, CO

Sources for this page

Verify at the official NPI Registry.