Individual provider Active NPI

Thomas Roschak, MD

  • Hematology & Oncology Physician
  • Auburn, CA
National Provider Identifier
1730252917
Registry record updated Oct 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
00A243690 Issued in CA
Practice address
11971 Heritage Oak Place
Auburn, CA 95603-2461
Phone
(530) 885-0644
Fax
(530) 885-6582
NPI assigned
Nov 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 00A243690 CA Primary

Addresses

Primary practice location

11971 Heritage Oak Place
Auburn, CA 95603-2461

Mailing address

11971 Heritage Oak Place
Auburn, CA 95603-2461
Phone (530) 885-0644

Other identifiers 1

IdentifierTypeStateIssuer
2705416MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00A243690CAMDHematology & Oncology Physician

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223942400000",
    "number": "1730252917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11971 HERITAGE OAK PLACE",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956032461",
            "telephone_number": "530-885-0644",
            "fax_number": "530-885-6582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11971 HERITAGE OAK PLACE",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956032461",
            "telephone_number": "530-885-0644",
            "fax_number": "530-885-6582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSCHAK",
        "first_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2008-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "00A243690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2705416",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.