Individual provider Active NPI

John Lawrence Roebel, M.D.

  • Pediatric Radiology Physician
  • Cincinnati, OH
National Provider Identifier
1891006607
Registry record updated Oct 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Radiology PhysicianTaxonomy code 2085P0229X
License
35. 126402 Issued in OH
Practice address
3333 Burnet Ave
MLC 5031
Cincinnati, OH 45229-3026
Phone
(513) 636-4504
Fax
(513) 636-8145
NPI assigned
Jun 25, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Radiology Physician 2085P0229X 35. 126402 OH Primary

Addresses

Primary practice location

3333 Burnet Ave
MLC 5031
Cincinnati, OH 45229-3026

Mailing address

3333 Burnet Ave
MLC 5031
Cincinnati, OH 45229-3026
Phone (513) 636-4504

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20161116002552 OH Practitioner - Pediatric Medicine 8022397900 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Wright State University Boonshoft School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dayton Pediatric Imaging IncGroup PAC ID 8224136601, 6 clinicians

Practice addresses (Care Compare)

1 Childrens Plaza
Dayton, OH 45404
Phone (937) 641-3888

Hospital & facility affiliations

  • Dayton Childrens Hospital Hospital, Dayton, OH, CCN 363306

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35. 126402OHMDPediatric Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shriners Hospitals for Children CurrentSince May 16, 2024 Accepting new patients
Dayton Pediatric Imaging Inc Pediatric Radiology CurrentSince May 1, 2017 Accepting new patients
Shriners Hospitals for Children CurrentSince May 16, 2024 Accepting new patients

Locations

1 Childrens Plz
Dayton, OH 45404
Phone (937) 641-3600

1 Childrens Plz
#2W
Dayton, OH 45404
Phone (513) 872-6000

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 2

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": "1277424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476230400000",
    "number": "1891006607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE",
            "address_2": "MLC 5031",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293026",
            "telephone_number": "513-636-4504",
            "fax_number": "513-636-8145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE",
            "address_2": "MLC 5031",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293026",
            "telephone_number": "513-636-4504",
            "fax_number": "513-636-8145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROEBEL",
        "first_name": "JOHN",
        "middle_name": "LAWRENCE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-25",
        "last_updated": "2016-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "OH",
            "license": "35. 126402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.