Philip M Roach

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

002469 Issued in CT

Practice address

100 Grand St
New Britain, CT 06052-2016

Phone

(860) 224-5011

NPI assigned

Oct 28, 2010

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 CT

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Connecticut Children'S Specialty Group, Inc.

  • Pediatrics Physician
  • Hartford, CT
  • NPI 1669448882

  Physician Assistant

  Medicare reassignment NPD
• Middlesex Hospital

  • Family Medicine Physician
  • Middletown, CT
  • NPI 1851350664
  Medicare reassignment NPD
• Middlesex Hospital

  • Community Based Hospice Care Agency
  • Middletown, CT
  • NPI 1003873233
  NPD
• Franklin Medical Group, PC

  • Internal Medicine Physician
  • Waterbury, CT
  • NPI 1780686964
  NPD (past)

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

{
    "created_epoch": "1288224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444003200000",
    "number": "1992005599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1090",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060956190",
            "telephone_number": "203-709-3117",
            "fax_number": "203-709-8625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 GRAND ST",
            "city": "NEW BRITAIN",
            "state": "CT",
            "postal_code": "060522016",
            "telephone_number": "860-224-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROACH",
        "first_name": "PHILIP",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-28",
        "last_updated": "2015-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "002469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Shantel Rivera
• Moesha L Rivera
• Olivia Rivera, LCSW
• Omar Rivera, LCSW
• Milton David Riveros, MS, OTR/L
• Tina Robbins, PA C
• Rymia Robinson
• Envy Robles
• Mary K Robotham, RPH, PHARMD
• Dana Rocco, PHARMD

• Physician Assistant in New Britain, CT
• Providers in New Britain, CT by specialty
• Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.