Tyler Roshak

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

2307 River Rd Ste 101
Louisville, KY 40206-5000

Phone

(502) 451-9000

NPI assigned

May 9, 2023

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

Medicare fee-for-service enrollment

Enrolled in KY

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, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Skin Group PLLCGroup PAC ID 0143114017, 4 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: troshak@skingroup.emadirect.md

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.

• Skin Group PLLC

  • MOHS-Micrographic Surgery Physician
  • Louisville, KY
  • NPI 1366564494
  Medicare reassignment Care Compare group
• Skin Group PLLC

  dba Dermatopathology Consultants

  • Dermatopathology Physician
  • Louisville, KY
  • NPI 1013925106
  NPD (past)

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

{
    "created_epoch": "1683590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1952091480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2307 RIVER RD STE 101",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402065000",
            "telephone_number": "502-583-6647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2307 RIVER RD STE 101",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402065000",
            "telephone_number": "502-451-9000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1868 W Hebron Ln Ste 200",
            "address_purpose": "LOCATION",
            "city": "Shepherdsville",
            "state": "KY",
            "postal_code": "401657493",
            "country_code": "US",
            "telephone_number": "502-583-6647",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSHAK",
        "first_name": "TYLER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-09",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rosenbloom & Rafson, P.S.C
• Philip M Rosenbloom, MD
• Elliott Michael Rosengarten, O.D.
• Mark A Rosenthal, LCSW
• Lynn A Rosenzweig Hensley, PSYD
• Katherine Rosin
• Ross Medical Equipment
• Adam Ross, M.D.
• Alysia Ross
• Anthony Ross

• Physician Assistant in Louisville, KY
• Providers in Louisville, KY by specialty
• Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; 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.