ANDREA AGNES ROELL PA-C NPI 1104489616

NPI Information

NPI: 1104489616
Provider Name: ANDREA AGNES ROELL, PA-C
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

PECOS Registration: Yes

Address:
9995 W NORTH AVE APT 256
WAUWATOSA, WI
ZIP 53226
Phone: (906) 221-5533
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Andrea Agnes Roell, PA-C is a surgical physician assistant in Wauwatosa, WI with 5 years of experience. Andrea Agnes Roell, PA-C NPI is 1104489616. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

9995 W NORTH AVE APT 256
WAUWATOSA, WI
ZIP 53226-512
Phone: (906) 221-5533

The NPI 1104489616 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/19/2019 and was last updated on 12/26/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363A00000X	Physician Assistant				No
2	363AS0400X	Physician Assistant	Surgical	4873	WISCONSIN	Yes
3	390200000X	Student in an Organized Health Care Education/Training Program				No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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