Susette R Roark, APRN

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

71006841A Issued in IN

Practice address

3900 Kresge Way
Ste 46
Louisville, KY 40207-4660

Phone

(502) 899-3858

Fax

(502) 899-3878

NPI assigned

Jan 30, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN, ME, MA, NJ, CT5 enrollments

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 5

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hospitalist Physicians of Massachusetts PCGroup PAC ID 4183038359, 84 clinicians

Hospitalist Physicians of Indiana PCGroup PAC ID 1052795986, 148 clinicians

Hospital Medicine Services of Maine LLCGroup PAC ID 1759621469, 34 clinicians

Hospital Medicine Associates LLCGroup PAC ID 9234156985, 208 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Vincent Hospital Hospital, Worcester, MA, CCN 220176
• Lawrence & Memorial Hospital Hospital, New London, CT, CCN 070007
• Northern Light Maine Coast Hospital Hospital, Ellsworth, ME, CCN 200050

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sroark113211@tuftsmedicine.direct-ci.com

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 Medicine Associates LLC

  • Hospitalist Physician
  • Baton Rouge, LA
  • NPI 1093758781

  CT, Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Hospital Medicine Services of Maine LLC

  • Hospitalist Physician
  • Ellsworth, ME
  • NPI 1538638432
  Medicare reassignment Care Compare group NPD
• Hospitalist Physicians of Indiana, PC

  • Hospitalist Physician
  • Fort Wayne, IN
  • NPI 1306576277

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Hospitalist Physicians of Massachusetts PC

  • Hospitalist Physician
  • Framingham, MA
  • NPI 1376145680

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Hospitalist Physicians of New Jersey PA

  • Hospitalist Physician
  • Edison, NJ
  • NPI 1588021851

  Nurse Practitioner

  Medicare reassignment NPD
• Massachusetts Acute Care Specialists PC

  • Internal Medicine Physician
  • Melrose, MA
  • NPI 1306134812
  Medicare reassignment NPD
• New Albany Hospitalist Group, LLC

  • Hospitalist Physician
  • New Albany, IN
  • NPI 1255084752
  Medicare reassignment NPD

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

• Lawrence and Memorial Hospital, Inc.

  dba Lawrence and Memorial Hospital

  • General Acute Care Hospital
  • New London, CT
  • NPI 1073530879
  Care Compare affiliation
• Lawrence and Memorial Hospital, Inc.

  dba Lawrence and Memorial Hospital

  • General Acute Care Hospital
  • New London, CT
  • NPI 1700092459
  Care Compare affiliation
• Maine Coast Regional Health Facilities

  dba Northern Light Maine Coast Hospital

  • General Acute Care Hospital
  • Ellsworth, ME
  • NPI 1740249739
  Care Compare affiliation
• VHS Acquisition Subsidiary Number 7 Inc

  dba Saint Vincent Hospital

  • General Acute Care Hospital
  • Worcester, MA
  • NPI 1538131214
  Care Compare affiliation

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

{
    "created_epoch": "1485734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1902343957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 COMMERCE CROSSINGS DR FL 3",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402292182",
            "telephone_number": "502-253-4900",
            "fax_number": "502-489-5750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 KRESGE WAY",
            "address_2": "STE 46",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074660",
            "telephone_number": "502-899-3858",
            "fax_number": "502-899-3878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROARK",
        "first_name": "SUSETTE",
        "middle_name": "R",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-30",
        "last_updated": "2023-03-07",
        "certification_date": "2023-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71006841A",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IN",
            "license": "71006841A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDS LICENSE",
            "identifier": "71006841B",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sroark61235@bhkydirect.com",
            "affiliation": "N",
            "address_1": "3900 Kresge Way Ste 42",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402074681",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Krista Gail Roach, APRN
• Madalin Roach, LPCA
• Robert Earl Roach Jr., D.C.
• Michelle Roadhouse
• Nicole Alexis Roan, APRN
• Michael Adam Robards, LCSW
• Shara Robb, B.A.
• Anita Rena Robbins, OTR/L
• Danique Robbins
• Emily K Robbins, SLP

• Acute Care Nurse Practitioner in Louisville, KY
• Providers in Louisville, KY by specialty
• Acute Care Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.