Individual provider Active NPI

Melissa A Rohrer, PA C

  • Physician Assistant
  • Tulsa, OK
National Provider Identifier
1790787356
Registry record updated Jul 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085002573 Issued in IL
Practice address
603 E Pine St
Tulsa, OK 74106-4849
Phone
(918) 587-2171
Fax
(918) 295-6155
NPI assigned
Aug 12, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085002573 IL Primary

Addresses

Primary practice location

603 E Pine St
Tulsa, OK 74106-4849

Mailing address

659 Highland Ave
Glen Ellyn, IL 60137-4019
Phone (630) 474-9254

Other identifiers 1

IdentifierTypeStateIssuer
200007950BMedicaidOK

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085002573ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Morton Comprehensive Health Services, Inc Past Accepting new patients
Vein Clinics of Chicago LLC Past Accepting new patients
Center for Minimally Invasive Therapies, LLC Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468972800000",
    "number": "1790787356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "659 HIGHLAND AVE",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601374019",
            "telephone_number": "630-474-9254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 E PINE ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741064849",
            "telephone_number": "918-587-2171",
            "fax_number": "918-295-6155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROHRER",
        "first_name": "MELISSA",
        "middle_name": "A",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-12",
        "last_updated": "2016-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085002573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200007950B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2016; 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.