JUSTIN KENT ROULSTON D.O.
NPI 1407144728
Emergency Medicine in Ada, OK

Q: What is Justin Roulston's NPI number?

The NPI number for Justin Roulston is 1407144728. It was assigned to this individual provider in the NPPES registry on July 20, 2011.

Q: What is Justin Roulston's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Q: When was this NPI record last updated?

The NPPES record for Justin Roulston was last updated on September 15, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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 July 20, 2011PECOS EnrolledAccepts Medicare Assignment

1921 STONECIPHER BLVD, ADA, OK 74820(580) 421-4570 Get Directions Write a Review

NPPES record last updated: September 15, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Justin Kent Roulston D.o. NPPES

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

JUSTIN KENT ROULSTON D.O. (NPI 1407144728) is an individual emergency medicine provider in Ada, Oklahoma, licensed in Oklahoma (5115) and active in the NPI registry since July 2011. He is enrolled in Medicare PECOS, is affiliated with Chickasaw Nation Medical Center, and is a graduate of Oklahoma State University College Of Osteopathic Medicine (2010).

NPPES Registry Identity

NPI1407144728

Entity TypeIndividualMale

Primary Taxonomy207P00000X

Provider Legal NameJUSTIN KENT ROULSTONCredential: D.O.

Location Address1921 STONECIPHER BLVDAda, OK 74820

Mailing Address1921 Stonecipher BlvdAda, OK 74820 · (580) 421-4570

Phone(580) 421-4570

Sole ProprietorYes

Medical School CMSOklahoma State University College Of Osteopathic MedicineGraduated 2010

Enumeration DateJuly 20, 2011

Last NPPES UpdateSeptember 15, 2016

✔ NPI 1407144728 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207P00000X

License✔ Licensed in OK · 5115

Definition

An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

1921 STONECIPHER BLVD, Ada, OK 74820

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Oklahoma.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

Justin Kent Roulston D.o. 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 ID4688840291

PECOS Enrollment IDI20120103000733

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 3

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.

Emergency department visit with low level of medical decision making 99283

An emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.

104 services101 patients

Emergency department visit with moderate level of medical decision making 99284

An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.

98 services95 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

85 services82 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Chickasaw Nation Medical Center

Acute Care Hospitals · Ada, OK

5/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number370180

Location1921 Stonecipher BlvdAda, OK 74820 · Pontotoc County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 74820 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

$82.46 typical visit price

range $53.00 – $162.61

Typical copayment $20.61 (range $13.25 – $40.65)

Most-billed visit code 99203

Established Patient

$94.27 typical visit price

range $16.68 – $132.40

Typical copayment $23.56 (range $4.17 – $33.10)

Most-billed visit code 99214

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 20

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

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