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Deactivated NPI 1417060773 Deactivated / Inactive NPI Male Practitioner

Dr. Paul M Roark , MD

Ophthalmology • Festus, MO

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Paul Roark has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 17, 2006
NPI Deactivation Date January 04, 2018
Total Practice Duration ~12 Years of Practice (2006 – 2018)

Professional Overview & Biography Verified Profile Summary

Dr. Paul Roark, MD was a registered Ophthalmology practicing in Festus, MO. Throughout an active medical career spanning 12 years, Dr. Roark provided care at the practice location at 1145 E GANNON DR until profile deactivation on 2018-01-04.

Practice Location & Contact Primary Location

Practice Address

1145 E Gannon Dr

Festus, MO 630282611

Telephone 6369378613
Fax 6369378614

Specialty Benchmarks & Practice Insights

Comparative analytics for Ophthalmology in Festus, MO

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 32.0 Yrs
State Avg: 30.4 Yrs
Regional Practice Density
4 Specialists

Practicing in Festus, MO (374 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Ophthalmology Primary Specialty

NUCC Taxonomy Code: 207W00000X

State License MO 32158

An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated January 04, 2018

Record deactivated on January 04, 2018

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 1145 E GANNON DR, FESTUS, MO 630282611 (Tel: 6369378613)

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Updated Business Mailing Address July 08, 2007

Registered at 4530 HAMPTON AVE, SAINT LOUIS, MO 631092238 (Tel: 3143529800)

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Provider Name / Credentials Updated July 08, 2007

Recorded as PAUL ROARK, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Ophthalmology (License #32158 in MO)

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Initial NPI Registration & Enumeration August 17, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1417060773
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 17, 2006
Last Update: July 08, 2007
Deactivation Date: January 04, 2018

Mailing Address

4530 Hampton Ave

Saint Louis, MO 631092238

Phone: 3143529800

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.