DR. JOHN L ROUSSALIS M.D.PC
NPI 1235252669
Surgery - Plastic and Reconstructive Surgery in Newark, DE

Active since April 09, 2007PECOS EnrolledAccepts Medicare Assignment
75.55/100
CMS Quality Rating
537 STANTON CHRISTIANA RD, NEWARK, DE 19713(302) 633-7550(302) 633-7556 Get Directions Write a Review

NPPES record last updated: June 23, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 23, 2021, Aug 28, 2019 (2 updates tracked since 2019).

About Dr. John L Roussalis M.d.pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JOHN L ROUSSALIS M.D.PC (NPI 1235252669) is an individual plastic and reconstructive surgery provider in Newark, Delaware, licensed in Pennsylvania (MD426938) and active in the NPI registry since April 2007. He is enrolled in Medicare PECOS and is a graduate of Creighton University School Of Medicine (2000).

NPPES Registry Identity

NPI1235252669
Entity TypeIndividualMale
Primary Taxonomy2086S0122X
Provider Legal NameDR. JOHN L ROUSSALISCredential: M.D.PC
Location Address537 STANTON CHRISTIANA RDNewark, DE 19713-2146
Mailing Address537 Stanton Christiana RdNewark, DE 19713-2146 · (302) 633-7550 · Fax (302) 633-7556
Fax(302) 633-7556
Sole ProprietorYes
Medical School CMSCreighton University School Of MedicineGraduated 2000
Enumeration DateApril 9, 2007
Last NPPES UpdateJune 23, 20212 updates tracked since enumeration
NPPES CertifiedJune 23, 2021
NPI 1235252669 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySurgery · Plastic and Reconstructive SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0122X
License Licensed in PA · MD426938
Definition
A surgeon who specializes in plastic and reconstructive surgery.
537 STANTON CHRISTIANA RD, Newark, DE 19713

Other Identifiers 2

OtherW21591WY · Ptan
Medicaid127068100WY

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. John L Roussalis M.d.pc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID648379065
PECOS Enrollment IDI20170807000644
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 28

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
264 services256 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
263 services246 patients
Preparation of skin graft site of trunk, arms, or legs, 100.0 sq cm or 1% body area for infants and children, or less 15002
This procedure involves preparing a specific area of the body (trunk, arms, or legs) for a skin graft. The area is cleaned and any dead tissue is removed to ensure a successful graft. The procedure covers an area of 100.0 sq cm or 1% of a child's body.
186 services175 patients
Complicated repair of wound of scalp, arms, or legs, 2.6-7.5 cm 13121
This is a procedure to repair a complex wound on your scalp, arm, or leg that is 2.6-7.5 cm long. It involves cleaning, removing damaged tissue, and stitching the wound to promote healing. It's performed under local or general anesthesia.
176 services161 patients
Application of skin substitute graft to wound of trunk, arms, or legs, 25.0 sq cm or less of wound 100.0 sq cm or less 15271
This procedure involves applying a skin substitute graft to a wound on the trunk, arms, or legs. The graft, a lab-grown skin, is used to cover a wound area of 25.0 sq cm or less, within a total wound area of 100.0 sq cm or less. It aids in healing and regeneration.
166 services28 patients
Complicated repair of wound of trunk, 2.6-7.5 cm 13101
This service involves the intricate repair of a wound on your body's main structure, between your neck and limbs. The wound measures 2.6-7.5 cm. The procedure includes deep-layer stitching and may involve repairing damaged tissue.
136 services127 patients

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

75.55/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality98.38
Promoting Interoperability99
Improvement Activities40
Cost20.97

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dermatology
537 STANTON CHRISTIANA RD, SUITE # 207
NEWARK, DE 19713
Physician Assistant
537 STANTON CHRISTIANA RD
NEWARK, DE 19713
Nurse Practitioner (Family)
537 STANTON CHRISTIANA RD, SUITE 201
NEWARK, DE 19713
Physician Assistant (Medical)
537 STANTON CHRISTIANA RD, SUITES 107,111,207 & 209
NEWARK, DE 19713
Dentist (General Practice)
537 STANTON CHRISTIANA RD, SUITE 211
NEWARK, DE 19713
Surgery
537 STANTON CHRISTIANA RD, SUITE 102
NEWARK, DE 19713
Internal Medicine (Rheumatology)
537 STANTON CHRISTIANA RD, SUITE 212
NEWARK, DE 19713
Surgery
537 STANTON CHRISTIANA RD, SUITE 102
NEWARK, DE 19713

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is John Roussalis's NPI number?

The NPI number for John Roussalis is 1235252669. It was assigned to this individual provider in the NPPES registry on April 9, 2007.

Where is John Roussalis located?

John Roussalis practices at 537 Stanton Christiana Rd, Newark, DE 19713. The listed phone number is (302) 633-7550.

What is John Roussalis's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Plastic and Reconstructive Surgery, with taxonomy code 2086S0122X.

Is John Roussalis enrolled in Medicare?

Yes. John Roussalis is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does John Roussalis accept?

Health plans from AmeriHealth Caritas Next and Highmark Blue Cross Blue Shield Delaware list John Roussalis as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for John Roussalis was last updated on June 23, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.