Jonathon R Roullard, CAA | |
11700 N Meridian St, Carmel, IN 46032-4656 | |
(317) 577-4200 | |
Not Available |
Full Name | Jonathon R Roullard |
---|---|
Gender | Male |
Speciality | Anesthesiology Assistant |
Experience | 7 Years |
Location | 11700 N Meridian St, Carmel, Indiana |
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 |
---|---|---|---|
1124556261 | NPI | - | NPPES |
23865827 | Other | NCCAA | |
264430I62 | Other | IN | MEDICARE PTAN |
1101755112 | Other | IN | ANTHEM PTAN |
095200260 | Other | IN | MEDICARE PTAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367H00000X | Anesthesiologist Assistant | 23865827 (* (Not Available)) | Secondary |
367H00000X | Anesthesiologist Assistant | 75000146A (Indiana) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Indiana University Health North Hospital | Carmel, IN | Hospital |
Iu Health West Hospital | Avon, IN | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Indiana University Health Care Associates Inc | 5799755864 | 905 |
Entity Name | Iu Anesthesiology Associates, Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1285684407 PECOS PAC ID: 5395730303 Enrollment ID: O20040419001228 |
Entity Name | Indiana University Health Care Associates Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1902032832 PECOS PAC ID: 5799755864 Enrollment ID: O20040727000955 |
Mailing Address | Practice Location Address |
---|---|
Jonathon R Roullard, CAA 250 N Shadeland Ave, Indianapolis, IN 46219-4959 Ph: () - | Jonathon R Roullard, CAA 11700 N Meridian St, Carmel, IN 46032-4656 Ph: (317) 577-4200 |
Solomon I Berkowitz, CAA Anesthesiologist Assistant Medicare: Medicare Enrolled Practice Location: 151 Pennsylvania Pkwy, Carmel, IN 46280 Phone: 317-577-4200 Fax: 317-577-4200 | |
Margaret Hajje, CAA Anesthesiologist Assistant Medicare: Medicare Enrolled Practice Location: 151 Pennsylvania Pkwy, Carmel, IN 46280 Phone: 317-577-4200 Fax: 317-577-4200 |