Individual provider Active NPI

Maurice R Roulhac, MD

  • Vascular Surgery Physician
  • Fayetteville, NC
National Provider Identifier
1801837109
Registry record updated Mar 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
9300304 Issued in NC
Practice address
1251 Oliver St
Fayetteville, NC 28304-4450
Phone
(910) 822-6587
Fax
(910) 426-6587
NPI assigned
Jun 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 9300304 NC Primary

Addresses

Primary practice location

1251 Oliver St
Fayetteville, NC 28304-4450

Mailing address

PO Box 2493
Durham, NC 27715-2493
Phone (919) 544-6318

Other identifiers 3

IdentifierTypeStateIssuer
73468OtherNCBCBS NC INDIV NO
8973468MedicaidNC
P00131858OtherNCMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20220317001108 CO Practitioner - Vascular Surgery 2860479532 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
University of South Florida College of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Colorado Medical Group PLLCGroup PAC ID 5890091409, 11 clinicians

Practice addresses (Care Compare)

1044 S 88TH St
Suite 105
Louisville, CO 80027-9418
Phone (813) 961-1331

Hospital & facility affiliations

  • HCA Healthone Mountain Ridge Hospital, Thornton, CO, CCN 060065

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal386
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Medical Group, PLLC Surgery CurrentSince Mar 4, 2022 Accepting new patients
Colorado Medical Group, PLLC Surgery Past Accepting new patients
Colorado Medical Group, PLLC Vascular Surgery Past Accepting new patients
Colorado Medical Group, PLLC Surgery PastSince Oct 1, 2020 Accepting new patients
Village Surgical Associates PA Past Accepting new patients
Colorado Medical Group, PLLC Surgery Past Accepting new patients

Locations

5657 S Himalaya St
Ste 210
Centennial, CO 80015

6979 S Holly Cir
Ste 125
Centennial, CO 80112

3535 S Lafayette St
Ste 100
Englewood, CO 80113
Phone (303) 761-7800

3665 John F Kennedy Pkwy
Bldg 200
Fort Collins, CO 80525

6179 S Balsam Way
Ste 200
Littleton, CO 80123
Phone (303) 933-2555

1551 Professional Ln
Unit 241
Longmont, CO 80501

1044 S 88th St
Ste 105
Louisville, CO 80027
Phone (303) 301-9019

9195 Grant St
Ste 300
Thornton, CO 80229
Phone (303) 280-2229

3810 Northdale Blvd
Ste 260
Tampa, FL 33624

3810 Northdale Blvd
Ste 150
Tampa, FL 33624
Phone (813) 683-4784

Interoperability endpoints

  • Direct secure messaging: maurice.roulhac@uvvc.eclinicaldirectplus.com

Organizations & group practices 6

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 4

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206576000000",
    "number": "1801837109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2493",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277152493",
            "telephone_number": "919-544-6318",
            "fax_number": "919-544-6336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1251 OLIVER ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044450",
            "telephone_number": "910-822-6587",
            "fax_number": "910-426-6587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROULHAC",
        "first_name": "MAURICE",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2008-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NC",
            "license": "9300304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC INDIV NO",
            "identifier": "73468",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8973468",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00131858",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.