DR. THOMAS PAUL ROEDER D.D.S.
NPI 1265558795
Dentist in Berkeley, CA

Q: What is Thomas Roeder's NPI number?

The NPI number for Thomas Roeder is 1265558795. It was assigned to this individual provider in the NPPES registry on March 22, 2007.

Q: What is Thomas Roeder's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Q: Is Thomas Roeder enrolled in Medicare?

No. Thomas Roeder has opted out of Medicare through March 11, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Thomas Roeder was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.

Active since March 22, 2007Opted out of Medicare · through Mar 11, 2027

914 THE ALAMEDA, BERKELEY, CA 94707(510) 526-1411 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Dr. Thomas Paul Roeder D.d.s. NPPES

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

DR. THOMAS PAUL ROEDER D.D.S. (NPI 1265558795) is an individual dentist in Berkeley, California, licensed in California (20448) and active in the NPI registry since March 2007. He has opted out of Medicare through March 11, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1265558795

Entity TypeIndividualMale

Primary Taxonomy122300000X

Provider Legal NameDR. THOMAS PAUL ROEDERCredential: D.D.S.

Location Address914 THE ALAMEDABerkeley, CA 94707-2308

Mailing Address98 Deer Park AveSan Rafael, CA 94901-2312 · (415) 453-0484

Phone(510) 526-1411

Sole ProprietorYes

Enumeration DateMarch 22, 2007

Last NPPES UpdateJuly 8, 2007

✔ NPI 1265558795 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in CA · 20448

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

914 THE ALAMEDA, Berkeley, CA 94707

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Thomas Paul Roeder D.d.s. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from March 11, 2015 through March 11, 2027.

Opt-Out Effective DateMarch 11, 2015

Opt-Out In Effect ThroughMarch 11, 2027Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94707 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$104.51 typical visit price

range $69.00 – $202.35

Typical copayment $26.12 (range $17.25 – $50.58)

Most-billed visit code 99203

Established Patient

$84.91 typical visit price

range $23.44 – $166.46

Typical copayment $21.22 (range $5.86 – $41.61)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 5

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

DR. BARRY RANDALL LIU D.D.S.

Dentist (General Practice)