| Michael L Roach, MD | |
|
712 Aviation Way, Caldwell, ID 83605-1154 | |
| (208) 302-7100 | |
| (208) 302-7155 |
| Full Name | Michael L Roach |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 38 Years |
| Location | 712 Aviation Way, Caldwell, Idaho |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528004389 | NPI | - | NPPES |
| 805573200 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD203385 (Oregon) | Secondary |
| 207Q00000X | Family Medicine | M7815 (Idaho) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Saint Alphonsus Regional Medical Center | Boise, ID | Hospital |
| Saint Alphonsus Medical Center - Nampa | Nampa, ID | Hospital |
| St. Alphonsus Medical Center - Baker City | Baker city, OR | Hospital |
| West Valley Medical Center | Caldwell, ID | Hospital |
| Saint Alphonsus Medical Center - Ontario, Inc | Ontario, OR | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Saint Alphonsus Regional Medical Center Inc | 3476462359 | 541 |
| Saint Alphonsus Medical Center- Ontario Inc | 1456488899 | 35 |
| Entity Name | Saint Alphonsus Regional Medical Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1649357716 PECOS PAC ID: 3476462359 Enrollment ID: O20040204001036 |
| Entity Name | Saint Alphonsus Medical Center- Ontario Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093034159 PECOS PAC ID: 1456488899 Enrollment ID: O20120229000024 |
| Mailing Address | Practice Location Address |
|---|---|
| Michael L Roach, MD 3340 E Goldstone Dr, Meridian, ID 83642-1026 Ph: (208) 302-7500 | Michael L Roach, MD 712 Aviation Way, Caldwell, ID 83605-1154 Ph: (208) 302-7100 |
Stacy Jane Lamers, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 315 E Elm St Ste 201, Caldwell, ID 83605 Phone: 208-514-2528 Fax: 208-375-2217 | |
Zachary A Leckenby, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 315 E Elm St # 201, Caldwell, ID 83605 Phone: 208-514-2528 | |
Megan A Schwehr, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 808 Cleveland Blvd, Caldwell, ID 83605 Phone: 208-459-1025 Fax: 208-466-5359 | |
Miss J'cinda J'nae Bitters, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 211 E Logan St Ste 301, Caldwell, ID 83605 Phone: 208-459-4667 Fax: 208-459-3372 | |
Zechariah Wilson, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 315 E Elm St # 201, Caldwell, ID 83605 Phone: 208-514-2528 Fax: 208-375-2217 | |
Graceful Iris Morris, FNP Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 712 Aviation Way, Caldwell, ID 83605 Phone: 208-302-7500 Fax: 208-302-7555 | |
Jessica D Blancett, DO Family Medicine Medicare: Medicare Enrolled Practice Location: 315 E Elm St # 201, Caldwell, ID 83605 Phone: 208-514-2528 |