Kelly Roschen, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

78062 Issued in MN

Practice address

1001 Hart Blvd Ste 100
Monticello, MN 55362-8929

Phone

(763) 682-1313

Fax

(763) 581-9090

NPI assigned

Apr 17, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 3

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kroschen210535@direct.northmemorial.com
• Direct secure messaging: kroschen289738@direct.vidanthealth.com
• Direct secure messaging: kroschen836854@direct.centracare.com

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.

• Centracare Health System-NR LLC

  dba CentraCare Health - Monticello Hospital

  • Critical Access Hospital
  • Monticello, MN
  • NPI 1275872772
  Medicare reassignment NPD
• Centracare Health System-NR LLC

  dba CentraCare - Monticello Specialty Clinic

  • Multi-Specialty Clinic/Center
  • Monticello, MN
  • NPI 1558600874
  Medicare reassignment NPD
• Stellis Health, PA

  dba Buffalo Clinic, Monticello Clinic, Albertville/St.Michael Clinic,

  • Multi-Specialty Clinic/Center
  • Buffalo, MN
  • NPI 1184664674
  Medicare reassignment NPD
• Stellis Health, PA

  • Multi-Specialty Clinic/Center
  • Monticello, MN
  • NPI 1013103050
  NPD
• Allina Health System

  dba Buffalo Hospital

  • General Acute Care Hospital
  • Buffalo, MN
  • NPI 1538123567
  NPD (past)
• Carolina Kids Pediatric Associates

  • Pediatrics Physician
  • Raleigh, NC
  • NPI 1558371286
  NPD (past)

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

{
    "created_epoch": "1555459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1710540505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 BLUE RIDGE ROAD",
            "address_2": "SUITE 100",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076475",
            "telephone_number": "919-881-9009",
            "fax_number": "919-881-8463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 HART BLVD STE 100",
            "city": "MONTICELLO",
            "state": "MN",
            "postal_code": "553628929",
            "telephone_number": "763-682-1313",
            "fax_number": "763-581-9090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 Highway 25 N",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "MN",
            "postal_code": "553131930",
            "country_code": "US",
            "telephone_number": "763-682-1313",
            "fax_number": "763-581-9090",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2605 Blue Ridge Road",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276076475",
            "country_code": "US",
            "telephone_number": "919-881-9009",
            "fax_number": "919-881-8463",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSCHEN",
        "first_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-17",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "78062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kroschen210535@direct.northmemorial.com",
            "affiliation": "N",
            "address_1": "1001 Hart Blvd Ste 100",
            "city": "Monticello",
            "state": "MN",
            "country_code": "US",
            "postal_code": "553628929",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kroschen289738@direct.vidanthealth.com",
            "affiliation": "N",
            "address_1": "2100 Stantonsburg Rd",
            "city": "Greenville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "278342818",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kroschen210535@direct.northmemorial.com",
            "affiliation": "N",
            "address_1": "1700 Highway 25 N",
            "city": "Buffalo",
            "state": "MN",
            "country_code": "US",
            "postal_code": "553131930",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• River Place Clinic Inc
• Shambeel H Rizvi, MD
• Cody Bernard Robeck, DC
• Randy Rokala, CRNA
• Maura Romanshek, PA-C
• Megan Rose, PT, DPT
• Saint Andrews House
• Dorothy Carol Saunders, D.C.
• Tracy J. Schauer, O.D.
• Michelle Schei

• Pediatrics Physician in Monticello, MN
• Providers in Monticello, MN by specialty
• Pediatrics Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.