Active NPI
Donald Jay Roshan Jr., DO
- Surgery Physician
- Rolla, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 2024024347
- Practice address
- 1060 W 10TH St
Rolla, MO 65401-2905 - Phone
- (855) 406-3324
- Fax
- (573) 458-8363
- NPI assigned
- May 24, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 2024024347 | MO | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | AZ |
Addresses
Primary practice location
1060 W 10TH St
Rolla, MO 65401-2905
Mailing address
1050 W 10TH St
Rolla, MO 65401-2905
Phone (573) 364-9000
Other practice location 1
1301 S Crismon Rd
Mesa, AZ 85209-3767
Phone (480) 373-2370
Other practice location 2
1000 W 10th St
Rolla, MO 65401-2905
Phone (573) 458-8899
Other practice location 3
1000 W 10th St
Rolla, MO 65401-2905
Phone (573) 364-9000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- At Still University of Health Sciences, College of Osteo Med, Kirksville, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1060 W 10TH St
Rolla, MO 65401-2905
Phone (855) 406-3324
Hospital & facility affiliations
- Phelps County Regional Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 42 |
| Hernia repair - groin (open) | 1-10 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 49 |
| Melanoma (skin cancer) excision | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pcrmc Medical Group, Inc | Current | Accepting new patients | |
| Phelps County Regional Medical Center | Current | Accepting new patients | |
| Phelps County Regional Medical Center | Current | Accepting new patients |
Locations
1201 Hauck Dr
Rolla, MO 65401
Phone (573) 364-8818
1050 W 10th St
Rolla, MO 65401
Phone (573) 364-9000
1060 W 10th St
Rolla, MO 65401
Phone (855) 406-3324
1000 W 10th St
Rolla, MO 65401
Phone (573) 364-9000
Organizations & group practices 3
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.
-
- Clinic/Center
- Rolla, MO
- NPI 1124237227
-
- General Acute Care Hospital
- Rolla, MO
- NPI 1891766051
-
- Rural Health Clinic/Center
- Rolla, MO
- NPI 1366066037
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Rehabilitation Hospital Unit
- Rolla, MO
- NPI 1346287455
-
- General Acute Care Hospital
- Rolla, MO
- NPI 1891766051
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1558656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782950400000",
"number": "1669039665",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1050 W 10TH ST",
"city": "ROLLA",
"state": "MO",
"postal_code": "654012905",
"telephone_number": "573-364-9000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1060 W 10TH ST",
"city": "ROLLA",
"state": "MO",
"postal_code": "654012905",
"telephone_number": "855-406-3324",
"fax_number": "573-458-8363"
}
],
"practiceLocations": [
{
"address_1": "1301 S Crismon Rd",
"address_purpose": "LOCATION",
"city": "Mesa",
"state": "AZ",
"postal_code": "852093767",
"country_code": "US",
"telephone_number": "480-373-2370",
"fax_number": "480-373-2375",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1000 W 10th St",
"address_purpose": "LOCATION",
"city": "Rolla",
"state": "MO",
"postal_code": "654012905",
"country_code": "US",
"telephone_number": "573-458-8899",
"fax_number": "573-341-5611",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1000 W 10th St",
"address_purpose": "LOCATION",
"city": "Rolla",
"state": "MO",
"postal_code": "654012905",
"country_code": "US",
"telephone_number": "573-364-9000",
"fax_number": "573-202-2484",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROSHAN",
"first_name": "DONALD",
"middle_name": "JAY",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-05-24",
"last_updated": "2026-07-02",
"certification_date": "2026-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MO",
"license": "2024024347",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "AZ",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rolla, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.