DR. JONATHAN DAVID ROE MD
NPI 1679120794
Student in an Organized Health Care Education/Training Program in Phoenix, AZ

Q: What is Jonathan Roe's NPI number?

The NPI number for Jonathan Roe is 1679120794. It was assigned to this individual provider in the NPPES registry on August 22, 2019.

Q: What is Jonathan Roe's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Jonathan Roe was last updated on May 8, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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 August 22, 2019PECOS Enrolled

1300 N 12TH ST STE 508, PHOENIX, AZ 85006(602) 839-3927 Get Directions Write a Review

NPPES record last updated: May 8, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 8, 2026, Aug 22, 2019 (2 updates tracked since 2019).

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About Dr. Jonathan David Roe Md NPPES

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

DR. JONATHAN DAVID ROE MD (NPI 1679120794) is an individual student in an organized health care education/training program in Phoenix, Arizona, licensed in Arizona (R82400) and active in the NPI registry since August 2019. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1679120794

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameDR. JONATHAN DAVID ROECredential: MD

Location Address1300 N 12TH ST STE 508Phoenix, AZ 85006-2849

Mailing Address1300 N 12th St Ste 508Phoenix, AZ 85006-2849 · (602) 839-3927

Phone(602) 839-3927

Sole ProprietorNo

Enumeration DateAugust 22, 2019

Last NPPES UpdateMay 8, 20262 updates tracked since enumeration

NPPES CertifiedMay 8, 2026

✔ NPI 1679120794 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

License✔ Licensed in AZ · R82400

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

1300 N 12TH ST STE 508, Phoenix, AZ 85006

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jonathan David Roe Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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.

TREVIN REYES MD

Student in an Organized Health Care Education/Training Program