Michael Dewayne Roach, DO is a medicare enrolled "Family Medicine" physician in Hallsville, Missouri. He graduated from medical school in 2009 and has 15 years of diverse experience with area of expertise as Family Practice. He is a member of the group practice Boone Physician Services Llc and his current practice location is
501 N Route B, Hallsville, Missouri. You can reach out to his office (for appointments etc.) via phone at
(573) 696-0500.
Michael Dewayne Roach is licensed to practice in Missouri (license number 2012008079) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1740592435.
Physician's Profile
Full Name | Michael Dewayne Roach |
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Gender | Male |
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Speciality | Family Practice |
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Experience | 15 Years |
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Location | 501 N Route B, Hallsville, Missouri |
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Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Michael Dewayne Roach graduated from medical school in 2009
NPI Data:
- NPI Number: 1740592435
- Provider Enumeration Date: 07/09/2010
- Last Update Date: 08/30/2022
Medicare PECOS Information:
- PECOS PAC ID: 7719153279
- Enrollment ID: I20121002000775
Medical Identifiers
Medical identifiers for Michael Dewayne Roach such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1740592435 | NPI | - | NPPES |
1740592435 | Medicaid | MO | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207Q00000X | Family Medicine | 4950 (Oklahoma) | Secondary |
207Q00000X | Family Medicine | 2012008079 (Missouri) | Primary |
Medical Facilities Affiliation
Group Practice Association
Group Practice Name | Group PECOS PAC ID | No. of Members |
Boone Physician Services Llc | 6507090644 | 226 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Michael Dewayne Roach allows following entities to bill medicare on his behalf.
Entity Name | Saint Francis Medical Center |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1356304489 PECOS PAC ID: 9931007929 Enrollment ID: O20040107000140 |
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Entity Name | Kneibert Clinic Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1104804699 PECOS PAC ID: 0446160212 Enrollment ID: O20040407000054 |
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Entity Name | Capital Region Medical Center |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1477980837 PECOS PAC ID: 4688573686 Enrollment ID: O20070323000507 |
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Entity Name | Boone Physician Services Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1760893259 PECOS PAC ID: 6507090644 Enrollment ID: O20131003000535 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Michael Dewayne Roach is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Michael Dewayne Roach, DO 501 N Route B, Hallsville, MO 65255-9266 Ph: (573) 696-0500 | Michael Dewayne Roach, DO 501 N Route B, Hallsville, MO 65255-9266 Ph: (573) 696-0500 |
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