Individual provider Active NPI

James A Roseberry, DO

  • Emergency Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1700832946
Registry record updated Jan 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2897 Issued in OK
Practice address
3617 NW Expressway
Oklahoma City, OK 73112-4405
Phone
(405) 835-2771
NPI assigned
May 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2897 OK Primary
Emergency Medicine Physician 207P00000X 34005489R OH

Addresses

Primary practice location

3617 NW Expressway
Oklahoma City, OK 73112-4405

Mailing address

2550 N Thunderbird Cir Ste 303
Mesa, AZ 85215-1219
Phone (602) 288-6776

Other identifiers 3

IdentifierTypeStateIssuer
000000315975OtherBCBS
0886975MedicaidOH
P00100022OtherRR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20220228002228 OK Practitioner - Family Practice 9537053988 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Resource Management LLCGroup PAC ID 4082753918, 53 clinicians

Practice addresses (Care Compare)

10701 N Rockwell Ave
Oklahoma City, OK 73162-4537
Phone (405) 470-1500

3617 NW Expressway
Oklahoma City, OK 73112-4405
Phone (405) 835-2771

5300 SE 29TH St
Oklahoma City, OK 73115-4702
Phone (405) 835-2770

9917 SE 15TH St
Midwest City, OK 73130-5504
Phone (405) 622-2070

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34005489ROHMDEmergency Medicine Physician
2897OKMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health, LLC CurrentSince Jul 22, 2023 Accepting new patients
Medical Resource Management, LLC CurrentSince Nov 16, 2021 Accepting new patients
Tulsa Emergency Medical Center Inc CurrentSince Nov 16, 2021 Accepting new patients
Oca MWC LP PastSince Jan 17, 2022 Accepting new patients
West Central Emergency Physicians Emergency Medicine Past Accepting new patients
Upper Valley Medical Center Past Accepting new patients

Locations

2550 N Thunderbird Cir
Ste 303
Mesa, AZ 85215
Phone (480) 289-7890

3617 NW Expressway
Oklahoma City, OK 73112
Phone (405) 835-2771

10601 S Western Ave
Ste 100
Oklahoma City, OK 73170

10701 N Rockwell Ave
Oklahoma City, OK 73162
Phone (405) 470-1500

2929 S Garnett Rd
Tulsa, OK 74129
Phone (918) 665-1520

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: james.roseberry.p8@direct.nextcare.nextgenshare.com
  • Direct secure messaging: james.roseberrydo.p10@direct.nextcare.nextgenshare.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641513600000",
    "number": "1700832946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 N THUNDERBIRD CIR STE 303",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852151219",
            "telephone_number": "602-288-6776",
            "fax_number": "480-776-0025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3617 NW EXPRESSWAY",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124405",
            "telephone_number": "405-835-2771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEBERRY",
        "first_name": "JAMES",
        "middle_name": "A",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "2897",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "34005489R",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000315975",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0886975",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR",
            "identifier": "P00100022",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.