| Susette R Roark, APRN | |
|
3900 Kresge Way, Ste 46, Louisville, KY 40207-4660 | |
| (502) 899-3858 | |
| (502) 899-3878 |
| Full Name | Susette R Roark |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 9 Years |
| Location | 3900 Kresge Way, Louisville, Kentucky |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902343957 | NPI | - | NPPES |
| 71006841B | Other | IN | CDS LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | 71006841A (Indiana) | Secondary |
| 363LA2100X | Nurse Practitioner - Acute Care | 71006841A (Indiana) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Melrosewakefield Healthcare | Melrose, MA | Hospital |
| Dupont Hospital Llc | Fort wayne, IN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Hospitalist Physicians Of Indiana Pc | 1052795986 | 133 |
| Hospital Medicine Services Of Maine Llc | 1759621469 | 30 |
| Massachusetts Acute Care Specialists Pc | 9234303082 | 36 |
| Entity Name | Hospitalist Physicians Of Indiana Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1306576277 PECOS PAC ID: 1052795986 Enrollment ID: O20220826000967 |
| Entity Name | New Albany Hospitalist Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1255084752 PECOS PAC ID: 4880041409 Enrollment ID: O20231103000792 |
| Mailing Address | Practice Location Address |
|---|---|
| Susette R Roark, APRN 5200 Commerce Crossings Dr Fl 3, Louisville, KY 40229-2182 Ph: (502) 253-4900 | Susette R Roark, APRN 3900 Kresge Way, Ste 46, Louisville, KY 40207-4660 Ph: (502) 899-3858 |
Jacob William Harvey Jr., APRN-FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 516 W Breckinridge St, Louisville, KY 40203 Phone: 502-648-7909 | |
Harold Dean O'brien, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1357 Bardstown Rd, Louisville, KY 40204 Phone: 502-897-6443 Fax: 502-897-3461 | |
Tricia L. Flake, ARNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 4402 Churchman Ave, Suite 410, Louisville, KY 40215 Phone: 502-367-6322 Fax: 502-380-3843 | |
Aimee Christine Mihalyov, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 10798 Dixie Hwy Ste 102, Louisville, KY 40272 Phone: 502-449-6464 Fax: 502-449-6465 | |
Amanda Danielle Saccone, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1930 Bishop Ln Fl 12, Louisville, KY 40218 Phone: 502-272-5220 Fax: 502-272-5117 | |
Celaida Lezcano, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 234 E Gray St Ste 670, Louisville, KY 40202 Phone: 502-629-4525 Fax: 502-629-4529 | |
Victoria Jean Shipman, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 315 E Broadway Fl 4, Louisville, KY 40202 Phone: 502-629-2500 |