Individual provider Active NPI

Walter J Roche, MD

  • Physical Medicine & Rehabilitation Physician
  • Baltimore, MD
National Provider Identifier
1871537688
Registry record updated Oct 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
D053763 Issued in MD
Practice address
3333 North Calvert Street
Suite 400
Baltimore, MD 21218
Phone
(410) 554-2270
Fax
(410) 261-2726
NPI assigned
Jun 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X D053763 MD Primary

Addresses

Primary practice location

3333 North Calvert Street
Suite 400
Baltimore, MD 21218

Mailing address

3333 North Calvert Street
Suite 400
Baltimore, MD 21218
Phone (410) 554-2270

Other identifiers 3

IdentifierTypeStateIssuer
521892838OtherTAX ID
60394904OtherMDBCBS
227000500MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20081007000117 MD Practitioner - Physical Medicine and RehabilitationPractitioner - Interventional Pain Management 5294803078 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Interventional Pain Management
Education
Ponce School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians
Agape Physical Therapy and Sports Rehabilitation LPGroup PAC ID 3870741390, 684 clinicians

Practice addresses (Care Compare)

12 Medstar Blvd
Bel Air, MD 21015-1798
Phone (410) 877-8088

12 Newport Dr
Suite a
Forest Hill, MD 21050-1758

1406 Crain S Hwy 106
Glen Burnie, MD 21061-4086
Phone (410) 768-6440

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

State licenses

LicenseStateTypeSpecialty
D053763MDMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC CurrentSince Jul 15, 2015 Accepting new patients
Medstar Medical Group II LLC CurrentSince Jul 15, 2015 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Union Memorial Hospital Past Accepting new patients
Greater Chesapeake Orthopedics Associates, LLC Past Accepting new patients

Locations

3333 N Calvert St
Ste 4100
Baltimore, MD 21218

3333 N Calvert St
Ste 400
Baltimore, MD 21218
Phone (410) 554-2270

12 Medstar Blvd
Ste 300
Bel Air, MD 21015
Phone (410) 296-6232

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

1406 Crain Hwy S
Ste 106
Glen Burnie, MD 21061
Phone (410) 768-6440

1407 York Rd
Ste 100A
Lutherville Timonium, MD 21093
Phone (410) 252-9090

412 Malcolm Dr
Ste 200
Westminster, MD 21157
Phone (410) 751-7930

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.

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320019200000",
    "number": "1871537688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 NORTH CALVERT STREET",
            "address_2": "SUITE 400",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21218",
            "telephone_number": "410-554-2270",
            "fax_number": "410-261-2726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 NORTH CALVERT STREET",
            "address_2": "SUITE 400",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21218",
            "telephone_number": "410-554-2270",
            "fax_number": "410-261-2726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROCHE",
        "first_name": "WALTER",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2011-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MD",
            "license": "D053763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "521892838",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "60394904",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "227000500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.