JACQUELINE L ROETHLISBERGER (NP) – Adult Health Nurse Practitioner, NPI 1366561870
Adult Health Nurse Practitioner
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
14,984 NURSE PRACTITIONER in OH
Provider Addresses for JACQUELINE L ROETHLISBERGER (NP)
PO BOX 636256 CENTRAL CREDENTIALING
CINCINNATI, OH 452630001
Phone: (513) 585-5505
Fax: (513) 585-5511
Type: Mailing
3533 SOUTHERN BOULEVARD
KETTERING, OH 45429
Phone: (937) 395-8020
Fax: (937) 395-8054
Type: Location
1 PRESTIGE PL STE 550
MIAMISBURG, OH 453426115
Phone: (937) 762-1310
Fax: (937) 522-8068
Type: Mailing
3700 SOUTHERN BLVD STE 201
KETTERING, OH 454291265
Phone: (855) 500-2873
Fax: (937) 281-3992
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 20 Open Payments records for all available years, with a total value of $1,687.
Total Amount is formed as General ($1,687) + Research ($0) + Ownership ($0) = $1,687.
Last reported payment date: 2024-12-16 • Largest payer in this snapshot: Myriad Genetic Laboratories, Inc. ($948).
Total Amount
$1,687
General + Research + Ownership
Payments
20
Total payment records
General Amount
$1,687
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-16
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Myriad Genetic Laboratories, Inc. | $948 |
| ABBVIE INC. | $302 |
| Tempus AI, Inc | $106 |
| Merck Sharp & Dohme LLC | $97 |
| AstraZeneca Pharmaceuticals LP | $77 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2007-05-23
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20070523000338 | I | Nurse Practitioner | OH | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 170 | 118 | $0 |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 87 | 35 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 40 | 28 | $0 |
Insurance plans in this area (ZIP 45263)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Geriatric Medicine, Hematology/Oncology | IL | |
| Nurse Practitioner | OH | |
| Hematology/Oncology, Internal Medicine | OH | |
| Radiation Oncology | OH | |
| Nurse Practitioner | OH | |
| O B S T E T R I C S/ G Y N E C O L O G Y | OH | |
| Orthopedic Surgery | OH | |
| Pulmonary Disease, Critical Care (Intensivists), Sleep Medicine | OH | |
| Physician Assistant | OH | |
| Hospitalist, Emergency Medicine | OH |
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