Individual provider Active NPI

Sohaila Y Roshan, MD

  • Internal Medicine Physician
  • Longview, TX
National Provider Identifier
1639105315
Registry record updated Jan 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
J8748 Issued in TX
Practice address
709 Hollybrook Dr Ste 4500
Longview, TX 75605-2412
Phone
(903) 757-6042
Fax
(903) 232-8260
NPI assigned
Jun 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X J8748 TX
Internal Medicine Physician 207R00000X J8748 TX Primary

Addresses

Primary practice location

709 Hollybrook Dr Ste 4500
Longview, TX 75605-2412

Mailing address

709 Hollybrook Dr Ste 4500
Longview, TX 75605-2412
Phone (903) 757-6042

Other identifiers 2

IdentifierTypeStateIssuer
P00338108OtherMEDICARE RR
174071406MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20050725000211 TX Practitioner - EndocrinologyPractitioner - Internal Medicine 4789611401 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
University of Texas Medical School at Houston, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associated Clinicians of East TexasGroup PAC ID 4789957440, 106 clinicians

Practice addresses (Care Compare)

709 Hollybrook Dr
Suite 4500
Longview, TX 75605-2412
Phone (903) 757-6042

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
J8748TXMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Clinicians of East Texas Internal Medicine CurrentSince Sep 1, 2017 Accepting new patients
GS Physician Services Internal Medicine Past Accepting new patients
Associated Clinicians of East Texas Past Accepting new patients
Marshall Health Services Inc Internal Medicine PastSince Sep 1, 2009 Accepting new patients
Bloomington Cardiology PC Past Accepting new patients

Locations

709 Hollybrook Dr
Ste 4500
Longview, TX 75605
Phone (903) 291-6030

707 Hollybrook Dr
Longview, TX 75605
Phone (903) 232-8501

707 Hollybrook Dr
Ste 500
Longview, TX 75605
Phone (903) 232-8276

1009 N 4th St
Ste A
Longview, TX 75601
Phone (903) 757-3808

Organizations & group practices 5

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 3

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": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1639105315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 HOLLYBROOK DR STE 4500",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756052412",
            "telephone_number": "903-757-6042",
            "fax_number": "903-232-8260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 HOLLYBROOK DR STE 4500",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756052412",
            "telephone_number": "903-757-6042",
            "fax_number": "903-232-8260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSHAN",
        "first_name": "SOHAILA",
        "middle_name": "Y",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-24",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "TX",
            "license": "J8748",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "J8748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P00338108",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "174071406",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

Verify at the official NPI Registry.