Colleen Mary Roback

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

25MP00593800 Issued in NJ

Practice address

705 Haddonfield Berlin Rd
Voorhees, NJ 08043-3714

Phone

(856) 679-0537

NPI assigned

May 11, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Colleen Mary Dykeman Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NJ

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Patient First New Jersey Physicians Group LLCGroup PAC ID 6608220322, 42 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: colleen.dykeman.p1@direct.fpcs.nextgenshare.com
• Direct secure messaging: njexchange@patientfirstclinics.com

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.

• Patient First New Jersey Physicians Group LLC

  • Urgent Care Clinic/Center
  • Glen Allen, VA
  • NPI 1285317750

  NJ

  Medicare reassignment Care Compare group
• Patient First Maryland Physician'S Group PC

  • Family Medicine Physician
  • Glen Allen, VA
  • NPI 1982733564

  NJ

  Medicare reassignment NPD
• Practice Associates Medical Group

  • Internal Medicine Physician
  • Morristown, NJ
  • NPI 1427016385
  Medicare reassignment
• Patient First New Jersey Physicians Group LLC

  • Family Medicine Physician
  • Woodbury, NJ
  • NPI 1396528980
  NPD
• Patients First Maryland Physicians Group P C

  • Family Medicine Physician
  • Cherry Hill, NJ
  • NPI 1114477270
  NPD

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

{
    "created_epoch": "1589155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755129600000",
    "number": "1992327159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 BARTLEY RD",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085271241",
            "telephone_number": "732-363-6140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 HADDONFIELD BERLIN RD",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080433714",
            "telephone_number": "856-679-0537"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "161 Bartley Rd",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "NJ",
            "postal_code": "085271241",
            "country_code": "US",
            "telephone_number": "732-363-6140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBACK",
        "first_name": "COLLEEN",
        "middle_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-11",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00593800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "NJExchange@patientfirstclinics.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "705 Haddonfield Berlin Rd",
            "city": "Voorhees",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080433714",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "COLLEEN",
            "last_name": "DYKEMAN",
            "middle_name": "MARY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Willie Rivera
• Stephanie Riviello, M.A. CCC-SLP
• Kwan Thanaporn Rivlin, M.D.
• Linda Rizzo, PT
• Shamika Roane, NP
• Barbara Theresa Roberts, M.D.
• Heather Diane Roberts, P.A.
• Sharon Lynn Roberts, MA, LPC, LCADC, NCC
• Katelyn Robertson
• Demetrius Robinson, MSW, LSW

• Medical Physician Assistant in Voorhees, NJ
• Providers in Voorhees, NJ by specialty
• Medical Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.