Individual provider Active NPI

David Alexander Roshal, D.O.

  • Neurology Physician
  • Turnersville, NJ
National Provider Identifier
1710143656
Registry record updated Feb 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
OT012347 Issued in PA
Practice address
435 Hurffville Cross Keys Rd
Turnersville, NJ 08012-2453
Phone
(856) 218-5634
Fax
(856) 218-5664
NPI assigned
Jul 30, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X OT012347 PA Primary

Addresses

Primary practice location

435 Hurffville Cross Keys Rd
Turnersville, NJ 08012-2453

Mailing address

435 Hurffville Cross Keys Rd
Turnersville, NJ 08012-2453
Phone (856) 218-5634

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20120803000034 NJ Practitioner - Neurology 1355597550 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

435 Hurffville Cross Keys Rd
Turnersville, NJ 08012-2453
Phone (856) 513-4124

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OT012347PAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kennedy Medical Group Practice, P.C. Neurology CurrentSince May 1, 2014 Accepting new patients
Kennedy Medical Group Practice, P.C. Neurology CurrentSince Jun 15, 2021 Accepting new patients
Kennedy Medical Group Practice PC CurrentSince May 1, 2014 Accepting new patients

Locations

457 Haddonfield Rd
Ste 110
Cherry Hill, NJ 08002
Phone (856) 406-4091

205 E Laurel Rd
Stratford, NJ 08084
Phone (856) 344-7360

435 Hurffville Cross Keys Rd
Turnersville, NJ 08012
Phone (856) 513-4124

1 Regulus Dr
#A
Turnersville, NJ 08012
Phone (609) 589-7770

165 Princeton Ave
West Deptford, NJ 08096
Phone (856) 384-0210

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1217376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361491200000",
    "number": "1710143656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 HURFFVILLE CROSS KEYS RD",
            "city": "TURNERSVILLE",
            "state": "NJ",
            "postal_code": "080122453",
            "telephone_number": "856-218-5634",
            "fax_number": "856-218-5664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 HURFFVILLE CROSS KEYS RD",
            "city": "TURNERSVILLE",
            "state": "NJ",
            "postal_code": "080122453",
            "telephone_number": "856-218-5634",
            "fax_number": "856-218-5664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSHAL",
        "first_name": "DAVID",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-30",
        "last_updated": "2013-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "PA",
            "license": "OT012347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Turnersville, NJ

Sources for this page

Verify at the official NPI Registry.