Individual provider Active NPI

John F. Roser Jr., D.O.

  • Family Medicine Physician
  • Fairfax, VA
National Provider Identifier
1730170853
Registry record updated Apr 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0102201281 Issued in VA
Practice address
4375 Fair Lakes CT
Fairfax, VA 22033-4234
Phone
(571) 432-2600
Fax
(571) 432-2795
NPI assigned
Oct 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0102201281 VA Primary

Addresses

Primary practice location

4375 Fair Lakes CT
Fairfax, VA 22033-4234

Mailing address

4375 Fair Lakes CT
Fairfax, VA 22033-4234
Phone (571) 432-2600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20140523000932 DC Order and Referring Only - Family PracticePractitioner - Family Practice 8527249291

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0102201281VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Arun K Gupta PC PastSince Apr 17, 2022 Accepting new patients

Organizations & group practices 1

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": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649894400000",
    "number": "1730170853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4375 FAIR LAKES CT",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220334234",
            "telephone_number": "571-432-2600",
            "fax_number": "571-432-2795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4375 FAIR LAKES CT",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220334234",
            "telephone_number": "571-432-2600",
            "fax_number": "571-432-2795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSER",
        "first_name": "JOHN",
        "middle_name": "F.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2022-04-14",
        "certification_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102201281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.