MALLORY CATHERINE ROUSHAR PA
NPI 1912791385
Physician Assistant in Chicago, IL

Q: What is Mallory Roushar's NPI number?

The NPI number for Mallory Roushar is 1912791385. It was assigned to this individual provider in the NPPES registry on April 8, 2025.

Q: What is Mallory Roushar's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Mallory Roushar was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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 April 08, 2025PECOS EnrolledAccepts Medicare Assignment

5841 S MARYLAND AVE, CHICAGO, IL 60637(888) 824-0200 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 11, 2025, Apr 8, 2025 (2 updates tracked since 2025).

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About Mallory Catherine Roushar Pa NPPES

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

MALLORY CATHERINE ROUSHAR PA (NPI 1912791385) is an individual physician assistant in Chicago, Illinois, licensed in Illinois (085011468) and active in the NPI registry since April 2025. She is enrolled in Medicare PECOS, is affiliated with The University Of Chicago Medical Center, and maintains a secondary practice location in Baton Rouge.

NPPES Registry Identity

NPI1912791385

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameMALLORY CATHERINE ROUSHARCredential: PA

Location Address5841 S MARYLAND AVEChicago, IL 60637-1443

Mailing Address150 Harvester Dr Ste 300Burr Ridge, IL 60527-5965

Phone(888) 824-0200

Sole ProprietorYes

Medical School CMSOtherGraduated 2025

Enumeration DateApril 8, 2025

Last NPPES UpdateSeptember 11, 20252 updates tracked since enumeration

NPPES CertifiedSeptember 11, 2025

✔ NPI 1912791385 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in IL · 085011468

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

Secondary Practice Location 1

Location 11972 Cherrydale AveBaton Rouge, LA 70808-2815 · Phone (517) 883-1008

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

Mallory Catherine Roushar Pa 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 ID3577068253

PECOS Enrollment IDI20250924001599

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.

Hospital Affiliations CMS Care Compare

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

The University Of Chicago Medical Center

Acute Care Hospitals · Chicago, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140088

Location5841 South MarylandChicago, IL 60637 · Cook County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60637 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

$94.06 typical visit price

range $60.08 – $183.39

Typical copayment $23.51 (range $15.02 – $45.84)

Most-billed visit code 99203

Established Patient

$74.80 typical visit price

range $18.97 – $148.12

Typical copayment $18.70 (range $4.74 – $37.03)

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 20

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

DR. DON MARTINEZ M.D.

Radiology (Diagnostic Radiology)