Michelle Beason Roush, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085006495 Issued in IL

Practice address

24600 W 127TH St Ste 340
Plainfield, IL 60585-9507

Phone

(815) 731-9110

Fax

(815) 731-9110

NPI assigned

Jan 29, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jul 18, 2024 through Jul 18, 2028

Merit-based Incentive Payment System (MIPS)

Final score

84.9 of 100Reported as group

Quality

75.91

Promoting interoperability

99

Improvement activities

40

Cost

74.6

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Lott Behavioral Health, LTD.

  • Multi-Specialty Clinic/Center
  • Lisle, IL
  • NPI 1558808923
  NPD (past)

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

{
    "created_epoch": "1517184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617753600000",
    "number": "1659879310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24600 W 127TH ST STE 340",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605859507",
            "telephone_number": "815-731-9110",
            "fax_number": "815-731-9110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24600 W 127TH ST STE 340",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605859507",
            "telephone_number": "815-731-9110",
            "fax_number": "815-731-9110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUSH",
        "first_name": "MICHELLE",
        "middle_name": "BEASON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-29",
        "last_updated": "2021-04-07",
        "certification_date": "2021-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085006495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mroush204692@direct.edward.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "24600 W 127th St Ste 340",
            "city": "Plainfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605859507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Brenda Roman
• Rooted Counseling LLC
• Rooted Presence and Purpose, LLC
• Jordan Roscoe, RBT
• Madalyn Joy Rossen, MS
• Veronica Yee Concepcion Rueda, PT, DPT
• Allison R Russell
• Brenna Russell, MSW, LSW
• Joseph Russell, DO
• Kathleen G Russo, MS CCC SLP L

• Physician Assistant in Plainfield, IL
• Providers in Plainfield, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.