Nathaniel D Roach, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

10001124A Issued in IN

Practice address

5050 N Clinton St
Fort Wayne, IN 46825-5886

Phone

(260) 484-8551

Fax

(260) 482-5060

NPI assigned

Jul 29, 2009

Last updated

Oct 23, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orthopaedics Northeast PCGroup PAC ID 9234024878, 80 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Orthopaedic Hospital at Parkview North Hospital, Fort Wayne, IN, CCN 150167
• Parkview Regional Medical Center Hospital, Fort Wayne, IN, CCN 150021

Merit-based Incentive Payment System (MIPS)

Final score

87.82 of 100Reported as group

Quality

85.67

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Orthopaedics Northeast PC

  dba DBA ONE Anesthesia Services

  • Orthopaedic Surgery Physician
  • Fort Wayne, IN
  • NPI 1740268796
  Medicare reassignment Care Compare group NPD
• Orthopaedics Northeast PC

  dba Surgery One

  • Ambulatory Surgical Clinic/Center
  • Fort Wayne, IN
  • NPI 1417936477
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Orthopaedic Hospital at Parkview North, LLC

  • Special Hospital
  • Fort Wayne, IN
  • NPI 1568664613
  Care Compare affiliation
• Parkview Hospital, Inc.

  dba Parkview Regional Medical Center

  • General Acute Care Hospital
  • Fort Wayne, IN
  • NPI 1366407603
  Care Compare affiliation

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

{
    "created_epoch": "1248825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540252800000",
    "number": "1841421583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5052 N CLINTON ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468255822",
            "telephone_number": "260-484-8551",
            "fax_number": "260-482-5060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 N CLINTON ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468255886",
            "telephone_number": "260-484-8551",
            "fax_number": "260-482-5060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11136 Parkview Circle Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468451730",
            "country_code": "US",
            "telephone_number": "260-484-8551",
            "fax_number": "260-482-5060",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1500 Provident Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "Warsaw",
            "state": "IN",
            "postal_code": "465803297",
            "country_code": "US",
            "telephone_number": "574-269-8301",
            "fax_number": "574-269-8302",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7920 W Jefferson Blvd",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468044168",
            "country_code": "US",
            "telephone_number": "260-484-8551",
            "fax_number": "260-482-5060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROACH",
        "first_name": "NATHANIEL",
        "middle_name": "D",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-29",
        "last_updated": "2018-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IN",
            "license": "10001124A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300006062",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Riverview Hospital (Englewood Health & Rehabilitation Center)
• Arnel Rizvic
• Denisa Rizvic, BCBA
• Thalaysay Roa
• Katrina Elisabeth Roach, PTA
• Philip C Roach, D.D.S.
• Stephany Roach
• Stacy L Roark
• Abigail Robben
• Jacob C Robbins

• Medical Physician Assistant in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Medical Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.