DR. ROAN JAMISON GLOCKER (NPI# 1164623849) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164623849 |
| Entity Type | Individual |
| Full Name | DR. ROAN JAMISON GLOCKER |
| Credential | MD |
| Practice Address |
990 South Ave Ste 210 Rochester NY 14620-2763 |
| Mailing Address |
601 Elmwood Ave Box 652 Rochester NY 14642-0001 |
| Practice Telephone | 5853419541 |
| Practice Fax Number | 5853419550 |
| Mailing Telephone | 5853419541 |
| Mailing Fax Number | 5853419550 |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2016-11-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
274719 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 03921208 | 05 |
| Street Address |
990 SOUTH AVE STE 210 |
| City | ROCHESTER |
| State | NY |
| Zip Code | 14620-2763 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063489839 | Roger M Olander | Obstetrics & Gynecology | 990 South Ave, Suite 104a, Rochester, NY 14620 | 2006-03-01 |
| 1861836652 | Highland's Women's Health | Obstetrics & Gynecology | 990 South Ave, Suite 103, Rochester, NY 14620-2763 | 2013-04-23 |
| 1033408810 | Katina Marie Foster | Obstetrics & Gynecology | 990 South Ave, Suite 104, Rochester, NY 14620-2740 | 2011-04-01 |
| 1730405887 | Brittany Marie Paivanas | Obstetrics & Gynecology | 990 South Ave, Suite 103, Rochester, NY 14620-2763 | 2010-04-14 |
| 1386968006 | Daniel Blakely King | Internal Medicine | 990 South Ave, Suite 207, Rochester, NY 14620-2763 | 2010-03-24 |
| 1295993368 | Stephen L. Kates, Md, PC | Orthopaedic Surgery | 990 South Ave, Suite 010, Rochester, NY 14620-2763 | 2008-05-27 |
| 1194917336 | Marion E. Olander | Physician Assistant | 990 South Ave, Rochester, NY 14620-2763 | 2007-08-13 |
| 1336359777 | Amanda J Victory | Obstetrics & Gynecology | 990 South Ave, Suite 104, Rochester, NY 14620-2763 | 2007-05-23 |
| 1184764524 | Southeast Obstetrics & Gynecology PC | Obstetrics & Gynecology | 990 South Ave, Suite 104, Rochester, NY 14620-2740 | 2007-02-07 |
| 1861568008 | Sylvia Farnand | Nurse Practitioner | 990 South Ave, Suite 104, Rochester, NY 14620 | 2006-11-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356974174 | Linda D Pratt | Speech-Language Pathologist | Rochester Hearing and Speech Center, 1000 Elmwood Ave Suite 400, Rochester, NY 14620 | 2020-02-20 |
| 1609417617 | Maisie Katherine Pipher | Physician Assistant | 110 Crittenden Blvd, Rochester, NY 14620 | 2019-10-01 |
| 1215592332 | Allison Mckeown | Student in an Organized Health Care Education/Training Program | 777 S. Clinton Avenue - Box Hh 37, Rochester, Ny 14620, Box Hh 37, Rochester, NY 14620 | 2019-05-03 |
| 1114495736 | Tabitha Domonique Griffin | Licensed Practical Nurse | 55 Forthill Terrace, Rochester, NY 14620 | 2018-11-13 |
| 1700371960 | Deborah Paul | Dermatology | 40 Celebration Dr # 697, Rochester, NY 14620 | 2018-06-28 |
| 1942725791 | Emily Catone | Nurse Practitioner | 252 Cobb Terrace, Rochester, NY 14620 | 2017-08-12 |
| 1104355593 | Acacia Palmer | Counselor | 150 Mount Hope Avenue, Rochester, NY 14620 | 2017-06-08 |
| 1750818803 | Meagan Michelle Goates | Student in an Organized Health Care Education/Training Program | 150 Crittenden Blvd, Rochester, NY 14620 | 2017-05-20 |
| 1386170470 | Kendall Battle | Licensed Practical Nurse | 479 South Ave Apt B, Rochester, NY 14620 | 2017-05-10 |
| 1285167700 | Gina Josette Kuehn | Student in an Organized Health Care Education/Training Program | 40 Celebration Dr # 278733, Rochester, NY 14620 | 2017-04-11 |
| Find all providers in zip 14620 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407297260 | Ryan Patrick Lydon | Surgery | 1445 Portland Ave Ste 108, Rochester, NY 14621-3008 | 2013-07-09 |
| 1063749927 | Joseph Edward Geary | Surgery | 95 Council Rock Ave, 95 Council Rock Ave, Rochester, NY 14610-2501 | 2009-11-12 |
| 1063421691 | Ronen Haeem Jhirad | Surgery | 3525 Buffalo Rd, Rochester, NY 14624-1119 | 2006-08-05 |
| 1700856275 | Bradley M Sweda | Surgery | 1135 W University Dr Ste 230, Rochester, MI 48307-1890 | 2006-01-25 |
| 1306822481 | Michael Southworth | Surgery | 6 Healthcare Dr Ste 1, Rochester, NH 03867-4499 | 2005-12-20 |
| 1134103054 | Michael C Stoner | Surgery | 200 White Spruce Blvd, Rochester, NY 14623-1605 | 2005-12-05 |
| 1679100937 | Jesse Chait | Surgery | 200 1st St Sw, Rochester, MN 55905-0002 | 2020-03-26 |
| 1235762972 | Mohammad Rachad Mohammad Walid Wehbe | Surgery | 601 Elmwood Avenue Box Surg, Rochester, NY 14642-8410 | 2020-02-21 |
| 1699235689 | Armin Farazdaghi | Surgery | 200 First Street Sw, Rochester, MN 55905-0001 | 2019-03-25 |
| 1376027409 | Sara Forsythe | Surgery | 601 Elmwood Ave, Rochester, NY 14642-0001 | 2018-09-25 |
| Find all providers in ROCHESTER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.