Edmund Joseph Roache, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

EDMUND JOSEPH ROACHE, M.D.

Practice address

200 Mullin St
Watertown, NY 13601-3619

Phone

(315) 785-8591

Fax

(315) 782-4475

NPI assigned

May 17, 2006

Organization subpart

No

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

Authorized official

Name

Edmund J Roache, M.D.NPI 1780636704

Title

Owner

Phone

(315) 785-8591

Specialties & licenses 1

Addresses

Tax ID family

Edmund J Roache MD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Edmund J Roache MD

  • Internal Medicine Physician
  • Watertown, NY
  • NPI 1245265321
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Edmund J Roache, M.D.

  • Internal Medicine Physician
  • Watertown, NY
  • NPI 1780636704
  NPD (past) Authorized official
• Charles J Moehs, MD

  • Adult Medicine Physician
  • Watertown, NY
  • NPI 1548286438
  NPD (past)

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669424602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 91",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136010091",
            "telephone_number": "315-782-4207",
            "fax_number": "315-782-8699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MULLIN ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136013619",
            "telephone_number": "315-785-8591",
            "fax_number": "315-782-4475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDMUND JOSEPH ROACHE, M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROACHE",
        "authorized_official_first_name": "EDMUND",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-785-8591",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• East Coast Audiology and Physical Therapy, PLLC
• Joan Ellen Ebblie, LAC, RN
• Kristen Eberly
• Barbara Anne Edgar, OTR/L
• Edmund J Roache MD
• Ehsoc
• Erica Eichner, LMSW
• Danielle Cathryn Eisel, PHARMD
• Heather L Eisenhauer, LMHC
• Ekouegan Ekoue-Totou, PTA

• Internal Medicine Physician in Watertown, NY
• Providers in Watertown, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.