Individual provider Active NPI

Eric A. Roach, MD

  • Radiation Oncology Physician
  • Minneapolis, MN
National Provider Identifier
1972122042
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
79639 Issued in MN
Practice address
909 Fulton St SE
Minneapolis, MN 55455-4800
Phone
(612) 273-8383
NPI assigned
Apr 9, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 79639 MN Primary

Addresses

Primary practice location

909 Fulton St SE
Minneapolis, MN 55455-4800

Mailing address

516 Delaware St SE FL 1
Minneapolis, MN 55455-0356

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250422001091 MN Practitioner - Radiation Oncology 3870917156 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Sanford School of Medicine of University of South Dakota, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Specialty ServicesGroup PAC ID 3072083286, 303 clinicians
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians

Practice addresses (Care Compare)

14500 99TH Ave N
Maple Grove, MN 55369-4730
Phone (763) 898-1000

909 Fulton St SE
Minneapolis, MN 55455-4800
Phone (612) 672-7422

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0553SDMDOptometrist
79639MNMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care CurrentSince Jun 16, 2025 Accepting new patients
Healtheast Medical Research Institute CurrentSince Jun 28, 2025 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Jun 16, 2025 Accepting new patients
University of Minnesota Health Clinics and Surgery Center, Inc. CurrentSince Jun 16, 2025 Accepting new patients
University of Minnesota Physicians Current Accepting new patients
Fairview Express Care CurrentSince Jun 16, 2025 Accepting new patients
University of Minnesota Physicians CurrentSince Jun 16, 2025 Accepting new patients
Healtheast Medical Research Insititue CurrentSince Jun 28, 2025 Accepting new patients
University of Minnesota Pediatric Dental Clinic CurrentSince Jun 16, 2025 Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Health Services Past Accepting new patients
Cardiothoracic Surgery Clinic of North Ms Past Accepting new patients

Locations

14500 99th Ave N
Ste LL200
Maple Grove, MN 55369
Phone (763) 898-1000

14500 99th Ave N
Maple Grove, MN 55369
Phone (763) 898-1000

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

516 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-3600

720 Washington Ave SE
Ste 200
Minneapolis, MN 55414
Phone (612) 730-1345

516 Delaware St SE
Fl 1
Minneapolis, MN 55455
Phone (612) 273-6004

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

1875 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-6700

5160 Fairview Blvd
Ste 1100
Wyoming, MN 55092

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 3

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": "1586390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759708800000",
    "number": "1972122042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 DELAWARE ST SE FL 1",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 FULTON ST SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554554800",
            "telephone_number": "612-273-8383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROACH",
        "first_name": "ERIC",
        "middle_name": "A.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-09",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MN",
            "license": "79639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.