NPIMap

Individual provider Active NPI

Simon Roh, M.D.

  • Vascular & Interventional Radiology Physician
  • Easton, PA
National Provider Identifier
1962638056
Registry record updated Jan 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
MD464827 Issued in PA
Practice address
3735 Nazareth Rd Ste 206
Easton, PA 18045-8346
Phone
(484) 526-4805
NPI assigned
Jun 3, 2009
Last updated
Jan 30, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 39717 IA
Vascular & Interventional Radiology Physician 2085R0204X 288048 NY
Vascular & Interventional Radiology Physician 2085R0204X 25MA10399800 NJ
Vascular & Interventional Radiology Physician 2085R0204X MD464827 PA Primary

Addresses

Primary practice location

3735 Nazareth Rd Ste 206
Easton, PA 18045-8346

Mailing address

3735 Nazareth Rd Ste 206
Easton, PA 18045-8346

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180802002672 PA Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 6305016155 Reassigns benefits to 3 organizations
I20180806003064 NJ Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 6305016155 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
University of Kansas School of Med (KC/Wich/Sal), 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Progressive Physician Assoc IncGroup PAC ID 1355243809, 164 clinicians
St Lukes Physician Group IncGroup PAC ID 6709798333, 2,161 clinicians

Practice addresses (Care Compare)

185 Roseberry St
Phillipsburg, NJ 08865-1690
Phone (908) 859-6700

279 State Route 31 S
Washington, NJ 07882-4098
Phone (484) 503-7546

3735 Nazareth Rd
Suite 206
Easton, PA 18045-8346
Phone (610) 882-2598

755 Memorial Pkwy
Phillipsburg, NJ 08865-2774

95 Highland Ave
Suite 130
Bethlehem, PA 18017-9483
Phone (610) 868-1100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.13 of 100Reported as apm
Quality
82.27
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
97.13 of 100Reported as apm
Quality
82.27
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
288048NYMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke's Warren Physician Group, PC Vascular & Interventional Radiology CurrentSince Sep 29, 2018 Accepting new patients
Gslpg, Inc CurrentSince Sep 4, 2022 Accepting new patients
St. Luke's Warren Physician Group, PC Current Accepting new patients
St. Luke's Warren Physician Group, PC CurrentSince Sep 29, 2018 Accepting new patients
St. Luke's Physician Group, Inc. CurrentSince Jul 23, 2018 Accepting new patients
St. Luke's Physician Group, Inc. Current Accepting new patients
St Luke's Physician Group Inc CurrentSince Jul 23, 2018 Accepting new patients
Progressive Physician Assoc Inc Diagnostic Radiology CurrentSince Jul 11, 2018 Accepting new patients
Progressive Physician Assoc, Inc. Diagnostic Radiology PastSince Jul 23, 2018 Accepting new patients

Locations

185 Roseberry St
Phillipsburg, NJ 08865
Phone (908) 213-6611

185 Roseberry St
Bldg 2ND
Phillipsburg, NJ 08865
Phone (908) 847-2619

279 State Route 31 S
Washington, NJ 07882
Phone (908) 689-2201

315 State Route 31 S
Washington, NJ 07882
Phone (908) 689-0777

95 Highland Ave
Ste 130
Bethlehem, PA 18017
Phone 61086811002

3735 Nazareth Rd
Ste 206
Easton, PA 18045

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

100 Paramount Blvd
Orwigsburg, PA 17961
Phone (272) 639-1000

Organizations & group practices 9

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.

Hospital & facility affiliations 10

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": "1243987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1962638056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3735 NAZARETH RD STE 206",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180458346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3735 NAZARETH RD STE 206",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180458346",
            "telephone_number": "484-526-4805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROH",
        "first_name": "SIMON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-03",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IA",
            "license": "39717",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NY",
            "license": "288048",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NJ",
            "license": "25MA10399800",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "PA",
            "license": "MD464827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Easton, PA

Sources for this page

Verify at the official NPI Registry.