Active NPI
Robert R Roeser, D.O.
- Internal Medicine Physician
- Newton, KS
National Provider Identifier
1689670960
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 207R00000X
- Practice address
- 715 Medical Center Dr
Suite 200
Newton, KS 67114-9056 - Phone
- (316) 283-6655
- NPI assigned
- Jun 22, 2005
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 207R00000X | KS | Primary |
Addresses
Primary practice location
715 Medical Center Dr
Suite 200
Newton, KS 67114-9056
Mailing address
715 Medical Center Dr
Suite 200
Newton, KS 67114-9056
Phone (316) 283-6655
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100640640-C | Medicaid | KS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Aug 1, 2017 through Aug 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 207R00000X | KS | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pawnee Valley Community Hospital Inc | Past | Accepting new patients | |
| Medical Specialties of Kansas, L.L.C. | Internal Medicine | Past | Accepting new patients |
| Galichia Medical Group, P.a. | Internal Medicine | Past | Accepting new patients |
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.
-
- Cardiovascular Disease Physician
- Wichita, KS
- NPI 1447238621
Internal Medicine
-
- Cardiovascular Disease Physician
- Wichita, KS
- NPI 1427036086
Internal Medicine
-
- General Practice Physician
- Larned, KS
- NPI 1912310822
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1404950400000",
"number": "1689670960",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "715 MEDICAL CENTER DR",
"address_2": "SUITE 200",
"city": "NEWTON",
"state": "KS",
"postal_code": "671149056",
"telephone_number": "316-283-6655"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "715 MEDICAL CENTER DR",
"address_2": "SUITE 200",
"city": "NEWTON",
"state": "KS",
"postal_code": "671149056",
"telephone_number": "316-283-6655"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROESER",
"first_name": "ROBERT",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-22",
"last_updated": "2014-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "KS",
"license": "207R00000X",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100640640-C",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Newton, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2014; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.