Individual provider Active NPI

Johannes B Roedl, MD

  • Diagnostic Radiology Physician
  • Philadelphia, PA
National Provider Identifier
1922254598
Registry record updated May 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD451859 Issued in PA
Practice address
111 S 11TH St
Suite 3390
Philadelphia, PA 19107-4824
Phone
(215) 955-6385
Fax
(215) 923-6754
NPI assigned
Aug 14, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X L-236648 MA
Diagnostic Radiology Physician 2085R0202X MD451859 PA Primary

Addresses

Primary practice location

111 S 11TH St
Suite 3390
Philadelphia, PA 19107-4824

Mailing address

111 S 11TH St
Suite 3390
Philadelphia, PA 19107-4824

Other identifiers 3

IdentifierTypeStateIssuer
1029327670002MedicaidPA
1029327670001MedicaidPA
0421499MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 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
I20140819000568 PA Practitioner - Diagnostic Radiology 2769609502 Reassigns benefits to 6 organizations
I20181113000085 NJ Practitioner - Diagnostic Radiology 2769609502 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians
Jefferson University Physicians of New Jersey PCGroup PAC ID 9931325131, 117 clinicians
800 Imaging Associates LLCGroup PAC ID 3173530029, 20 clinicians
Jefferson University Radiology Associates LLCGroup PAC ID 7315845708, shared by 3 NPIs, 110 clinicians

Practice addresses (Care Compare)

111 S 11TH St
3Rd FLR Suite 3390
Philadelphia, PA 19107-5098
Phone (800) 858-1662

2000 Westinghouse Dr
Cranberry Township, PA 16066-5238

435 Hurffville Cross Keys Rd
Turnersville, NJ 08012-2453
Phone (856) 582-2500

443 Laurel Oak Rd
Voorhees, NJ 08043-4419

800 W State St
Suite 203
Doylestown, PA 18901-5842
Phone (215) 345-4568

850 Walnut St
Jefferson Outpatient Imaging
Philadelphia, PA 19107-5109
Phone (610) 831-0500

999 Route 73 N 101
Jefferson Outpatient Imaging
Marlton, NJ 08053-1227
Phone (856) 424-2929

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L-236648MAMDInternal Medicine Physician
MD451859PAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson University Radiology Associates LLC Diagnostic Radiology Current Accepting new patients
Jefferson University Physicians Internal Medicine CurrentSince Jul 1, 2014 Accepting new patients
Jefferson University Physicians of New Jersey, P.C. Internal Medicine CurrentSince Dec 31, 2023 Accepting new patients
Jefferson University Radiology Associates, LLC Diagnostic Radiology CurrentSince Jul 1, 2014 Accepting new patients
Jeanes Radiology Associates LLC Diagnostic Radiology CurrentSince May 17, 2017 Accepting new patients
Jefferson University Physicians Internal Medicine CurrentSince Jul 1, 2014 Accepting new patients
Rittenhouse Imaging Center, LLC Diagnostic Radiology CurrentSince May 17, 2017 Accepting new patients
Jefferson University Radiology Associates, LLC Diagnostic Radiology CurrentSince Sep 3, 2019 Accepting new patients
Lebanon Diagnostic Imaging, LLC Diagnostic Radiology CurrentSince May 17, 2017 Accepting new patients
Insight Health Corp PastSince May 17, 2017 Accepting new patients

Locations

999 Route 73 N
Ste 101
Marlton, NJ 08053
Phone (856) 424-2929

443 Laurel Oak Rd
Ste 130
Voorhees, NJ 08043
Phone (856) 741-0122

462 Gateway Ave
Chambersburg, PA 17201
Phone (717) 263-4999

150 E Pennsylvania Ave
Downingtown, PA 19335
Phone (215) 772-9674

800 W State St
Ste 203
Doylestown, PA 18901
Phone (215) 345-4568

1 W Germantown Pike
Norristown, PA 19401
Phone (610) 277-3202

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

111 S 11th St
Philadelphia, PA 19107
Phone (215) 955-6161

111 S 11th St
Ste 3390
Philadelphia, PA 19107
Phone (215) 955-2900

111 S 11th St
#3390
Philadelphia, PA 19107
Phone (215) 955-2900

1200 Constitution Ave
Ste 120
Philadelphia, PA 19112
Phone (215) 755-1076

850 Walnut St
Philadelphia, PA 19107
Phone (215) 503-4900

111 S 11th St
Fl 3
William Penn Annex West, PA 19107
Phone (215) 955-4804

Organizations & group practices 11

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": "1218672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430784000000",
    "number": "1922254598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 S 11TH ST",
            "address_2": "SUITE 3390",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S 11TH ST",
            "address_2": "SUITE 3390",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074824",
            "telephone_number": "215-955-6385",
            "fax_number": "215-923-6754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROEDL",
        "first_name": "JOHANNES",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-14",
        "last_updated": "2015-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "L-236648",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD451859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1029327670002",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1029327670001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0421499",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.