Active NPI
Joshua Roose, DO
- Sports Medicine (Family Medicine) Physician
- Henderson, NV
National Provider Identifier
1962018671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Family Medicine) Physician
- License
- CL0963
- Practice address
- 100 N Green Valley Pkwy Ste 325
Henderson, NV 89074-6393 - Phone
- (702) 986-0921
- NPI assigned
- Sep 17, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Family Medicine) Physician | 207QS0010X | OS21760 | FL | |
| Sports Medicine (Family Medicine) Physician | 207QS0010X | 20A24512 | CA | |
| Sports Medicine (Family Medicine) Physician | 207QS0010X | CL0963 | NV | Primary |
Addresses
Primary practice location
100 N Green Valley Pkwy Ste 325
Henderson, NV 89074-6393
Mailing address
100 N Green Valley Pkwy Ste 325
Henderson, NV 89074-6393
Phone (702) 986-0921
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Michigan State University College of Osteopathic Medicine, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
13949 Mono Way
Sonora, CA 95370-2807
Phone (209) 533-5371
Hospital & facility affiliations
- Promedica Toledo Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24512 | CA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sierra Orthopedic Institute Medical Corporation | Current | Accepting new patients |
Locations
13949 Mono Way
Sonora, CA 95370
Phone (209) 213-9184
Organizations & group practices 1
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.
-
- Sports Medicine (Orthopaedic Surgery) Physician
- Sonora, CA
- NPI 1487967303
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Toledo, OH
- NPI 1407854771
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782432000000",
"number": "1962018671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 N GREEN VALLEY PKWY STE 325",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890746393",
"telephone_number": "702-986-0921"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 N GREEN VALLEY PKWY STE 325",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890746393",
"telephone_number": "702-986-0921"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROOSE",
"first_name": "JOSHUA",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-09-17",
"last_updated": "2026-06-26",
"certification_date": "2026-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "207QS0010X",
"taxonomy_group": "",
"desc": "Family Medicine, Sports Medicine",
"state": "FL",
"license": "OS21760",
"primary": false
},
{
"code": "207QS0010X",
"taxonomy_group": "",
"desc": "Family Medicine, Sports Medicine",
"state": "CA",
"license": "20A24512",
"primary": false
},
{
"code": "207QS0010X",
"taxonomy_group": "",
"desc": "Family Medicine, Sports Medicine",
"state": "NV",
"license": "CL0963",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Henderson, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2026; 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.