NPIMap

Individual provider Active NPI

Robert D. Roether, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Fort Wayne, IN
National Provider Identifier
1801278841
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
01087364A Issued in IN
Practice address
7910 W Jefferson Blvd Ste 102
Fort Wayne, IN 46804-4159
Phone
(260) 458-3555
Fax
(260) 458-3530
NPI assigned
Jun 26, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 01087364A IN Primary

Addresses

Primary practice location

7910 W Jefferson Blvd Ste 102
Fort Wayne, IN 46804-4159

Mailing address

6920 Pointe Inverness Way Ste 200
Fort Wayne, IN 46804-7934
Phone (260) 479-3514

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address robert.roether@lutheranhealthnetwork.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, OH2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220706002298 IN Practitioner - Thoracic Surgery 2062725609 Reassigns benefits to 1 organization
I20260108003092 OH Practitioner - Thoracic Surgery 2062725609 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Thoracic Surgery
Education
University of Toledo College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Promedica Central PhysiciansGroup PAC ID 2365348190, 785 clinicians
Lutheran Medical Group LLCGroup PAC ID 4981751617, 251 clinicians

Practice addresses (Care Compare)

2109 Hughes Dr
Suite 760
Toledo, OH 43606-5111
Phone (419) 291-7555

7910 W Jefferson Blvd
Suite 102
Fort Wayne, IN 46804-4159
Phone (260) 436-2424

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.99 of 100Reported as apm
Quality
77.41
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)16
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)1-10
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Central Physicians CurrentSince Dec 29, 2025 Accepting new patients
Promedica Central Physicians Surgery CurrentSince Dec 29, 2025 Accepting new patients
Lutheran Medical Group LLC CurrentSince Aug 1, 2022 Accepting new patients
Lutheran Medical Group LLC CurrentSince Aug 1, 2022 Accepting new patients

Locations

7910 W Jefferson Blvd
Ste 102
Fort Wayne, IN 46804
Phone (260) 436-2424

6920 Pointe Inverness Way
Ste 200
Fort Wayne, IN 46804
Phone (260) 479-3514

2516 E DuPont Rd
Fort Wayne, IN 46825
Phone (260) 434-6076

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

2109 Hughes Dr
Ste 760
Toledo, OH 43606
Phone (419) 291-7555

Interoperability endpoints

  • Direct secure messaging: robert.roether@lutheranhealthnetwork.cernerdirect.com

Organizations & group practices 4

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 10

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": "1435276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1801278841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6920 POINTE INVERNESS WAY STE 200",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468047934",
            "telephone_number": "260-479-3514",
            "fax_number": "260-479-3520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7910 W JEFFERSON BLVD STE 102",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044159",
            "telephone_number": "260-458-3555",
            "fax_number": "260-458-3530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROETHER",
        "first_name": "ROBERT",
        "middle_name": "D.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-26",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "IN",
            "license": "01087364A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "robert.roether@lutheranhealthnetwork.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "AMR Direct Address",
            "address_1": "7910 W Jefferson Blvd Ste 102",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468044159",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.