DR. JEFFREY C ROACH (NPI# 1861425811) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861425811 |
| Entity Type | Individual |
| Full Name | DR. JEFFREY C ROACH |
| Credential | M.D. |
| Practice Address |
300 Mount Auburn St Suite 308 Cambridge MA 02138-5600 |
| Practice Telephone | 6163541010 |
| Practice Fax Number | 6173547961 |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2011-09-26 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | 213496 | MA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 0195871 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114949351 | Jeffrey Paul Roach | Psychologist | 884 Brighton Rd, Tonawanda, NY 14150-8169 | 2006-07-24 |
| Street Address |
300 MOUNT AUBURN ST SUITE 308 |
| City | CAMBRIDGE |
| State | MA |
| Zip Code | 02138-5600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568466316 | Frederick W Ruymann | Internal Medicine | 300 Mount Auburn St, Ste 405, Cambridge, MA 02138-5665 | 2005-06-09 |
| 1134688120 | Peymaan Sam Banankhah | Internal Medicine | 300 Mount Auburn St, Cambridge, MA 02138-5600 | 2019-03-18 |
| 1508389636 | Emily Holmes | Nurse Practitioner | 300 Mount Auburn St, Cambridge, MA 02138-5600 | 2017-07-20 |
| 1396277455 | Dr. Susan Pories | Surgery | 300 Mount Auburn St, Suite 509, Cambridge, MA 02138-5600 | 2017-03-29 |
| 1992243554 | Allison Vandermeulen | Specialist/Technologist, Other | 300 Mount Auburn St, Suite 505, Cambridge, MA 02138-5600 | 2017-02-03 |
| 1982142519 | Jessica Jeanne Sullivan | Registered Nurse | 300 Mount Auburn St, Cambridge, MA 02138-5600 | 2017-02-02 |
| 1578017497 | Andrew Dallahan Donnelly | Registered Nurse | 300 Mount Auburn St, Suite 517, Cambridge, MA 02138-5600 | 2016-08-09 |
| 1447634670 | Troy Tweiten | Internal Medicine | 300 Mount Auburn St, Cambridge, MA 02138-5600 | 2015-07-17 |
| 1235528696 | Laura Boldyrev | Nurse Practitioner | 300 Mount Auburn St, Suite 509, Cambridge, MA 02138-5600 | 2015-01-22 |
| 1649673724 | Cambridge Digestive Health PC | Internal Medicine | 300 Mount Auburn St, Suite 405, Cambridge, MA 02138-5600 | 2014-10-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922618610 | Khushboo Vijay Bhatia | Student in an Organized Health Care Education/Training Program | Internal Medicine Residency Program, Mount Auburn Hospi, 330 Mt. Auburn Street, Cambridge, MA 02138 | 2020-08-06 |
| 1780204156 | Ashna Grover | Student in an Organized Health Care Education/Training Program | 330 Mt Auburn Street Mount Auburn Hospital, Internal Medicine Residency Program, Cambridge, MA 02138 | 2020-04-25 |
| 1790330298 | Cambridge Periodontics LLC | Dentist | 1692 Massachusetts Ave Ste 3, Cambridge, MA 02138 | 2019-08-02 |
| 1295389765 | Yulia Levit | Technician/Technologist | 1208 Massachussets Av, Cambridge, MA 02138 | 2019-08-01 |
| 1720645393 | Chinmay Tusharkumar Jani | Student in an Organized Health Care Education/Training Program | Mount Auburn Hospital, 330 Mt Auburn Street, Cambridge, MA 02138 | 2019-05-20 |
| 1386209831 | Alexander Ryan Walker | Internal Medicine | 300 Mount Auburn Street Mount Auburn Hospital, Dept. of Medicine, Cambridge, MA 02138 | 2019-05-09 |
| 1659844868 | Aimee Hsieh | Social Worker | 525 Mount Auburn Street, Cambridge, MA 02138 | 2019-01-10 |
| 1043733389 | Armida Fruzzetti | Psychologist | 900 Concord Avenue, Cambridge, MA 02138 | 2017-07-19 |
| 1174984827 | Jenna Mezin Schmid | Psychologist | 75 Mt Auburn St 4 East, Harvard University Health Services, Cambridge, MA 02138 | 2016-03-09 |
| 1316313208 | Kelly Abbott | Optometrist | 12 Eliot St., Cambridge, MA 02138 | 2015-08-14 |
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| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750397824 | Joel Richard Link | Otolaryngology | 1210 Neal Dr, Cambridge, OH 43725-1143 | 2006-07-31 |
| 1003817396 | Morris Z Effron Md-cambridge Ent & Allergy Associates Pa | Otolaryngology | 4 Aurora St, Cambridge Ear Nose Throat and Allergy Assoc Pa, Cambridge, MD 21613-1902 | 2005-08-09 |
| 1417272410 | Christian Soneru | Otolaryngology | 300 Mount Auburn St, 308, Cambridge, MA 02138-5600 | 2010-04-01 |
| 1740417492 | James Christopher Spencer | Otolaryngology | 300 Mount Auburn St, Suite 308, Cambridge, MA 02138-5600 | 2009-06-19 |
| 1235395500 | Erik Victor Berg | Otolaryngology | 1493 Cambridge St, Cambridge, MA 02139-1047 | 2008-08-05 |
| 1083743835 | Cambridge Otolaryngology | Otolaryngology | 300 Mount Auburn St, Suite 308, Cambridge, MA 02138-5600 | 2007-03-05 |
| 1164534343 | Weiru Shao | Otolaryngology | 1493 Cambridge St, Surgery, Cambridge, MA 02139-1047 | 2006-08-31 |
| 1518979319 | Ent Surgery Associates LLC | Otolaryngology | 725 Concord Ave, Suite 2300, Cambridge, MA 02138-1040 | 2006-08-12 |
| 1356350995 | Pamela F. Diamond | Otolaryngology | 1611 Cambridge St, Cambridge, MA 02138-4302 | 2006-08-05 |
| 1548249048 | Richard Hillel | Otolaryngology | 300 Mount Auburn St, Suite 308, Cambridge, MA 02138-5600 | 2006-01-12 |
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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.