Individual provider Active NPI

Michelle Ayola Roett, MD

  • Family Medicine Physician
  • Colmar Manor, MD
National Provider Identifier
1821013236
Registry record updated Oct 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD035386 Issued in DC
Practice address
4151 Bladensburg Rd
Colmar Manor, MD 20722-1928
Phone
(301) 699-7700
Fax
(301) 779-9001
NPI assigned
Jul 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2018

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 MD035386 DC Primary

Addresses

Primary practice location

4151 Bladensburg Rd
Colmar Manor, MD 20722-1928

Mailing address

1150 Varnum St NE
Washington, DC 20017
Phone (202) 269-7000

Other practice location 1

1150 Varnum St NE
Washington, DC 20017
Phone (202) 269-7000

Other identifiers 3

IdentifierTypeStateIssuer
P00431129OtherDCMEDICARE RAILROAD
010112500MedicaidMD
038312400MedicaidDC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070209000265 DC Practitioner - Family Practice 3971505603 Reassigns benefits to 1 organization
I20210224000349 MD Practitioner - Family Practice 3971505603 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Georgetown University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

1145 19TH St NW
311 MMG at 19TH Street NW
Washington, DC 20036-3735
Phone (202) 429-2401

4151 Bladensburg Rd
Colmar Manor, MD 20722-1928
Phone (301) 699-7700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.34 of 100Reported as group
Quality
67.9
Promoting interoperability
100
Improvement activities
40
Cost
69.47

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC CurrentSince Dec 1, 2020 Accepting new patients
Medstar Medical Group II LLC CurrentSince Jul 1, 2019 Accepting new patients
Guh Kids Mobile Medical Clinic Program, LLC Past Accepting new patients

Locations

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

3800 Reservoir Rd NW
Washington, DC 20007
Phone (202) 687-2203

29955 Three Notch Rd
Ste 100
Charlotte Hall, MD 20622
Phone (301) 290-5300

4151 Bladensburg Rd
Colmar Manor, MD 20722
Phone (301) 699-7700

1406 Crain Hwy S
Glen Burnie, MD 21061
Phone (410) 768-6440

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.

Hospital & facility affiliations 1

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540166400000",
    "number": "1821013236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 VARNUM ST NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "20017",
            "telephone_number": "202-269-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4151 BLADENSBURG RD",
            "city": "COLMAR MANOR",
            "state": "MD",
            "postal_code": "207221928",
            "telephone_number": "301-699-7700",
            "fax_number": "301-779-9001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1150 Varnum St NE",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "20017",
            "country_code": "US",
            "telephone_number": "202-269-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROETT",
        "first_name": "MICHELLE",
        "middle_name": "AYOLA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2018-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DC",
            "license": "MD035386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00431129",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010112500",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038312400",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colmar Manor, MD

Sources for this page

Verify at the official NPI Registry.