Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Robert William Roethel, PA

Individual provider Surgical Physician Assistant · NPI 1457971921

Robert William Roethel, PA is a Physician Assistant in Valdosta, Georgia. Qualified in 2020, 6 years ago. Practices with Hughston Clinic PC, a 112-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
6
Licensed in
GA
In the registry since
2020
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

4340 Kings Way
Valdosta, GA 31602-6921
Phone: (229) 333-9736
Fax: (478) 353-1170
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 100 Medical Dr Ste 400, Dublin, GA 31021-2561 — (478) 353-1166

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 9762 (GA)

Record details

NPI number1457971921
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedApril 24, 2020
Last updated in NPPESNovember 19, 2020
Certification dateNovember 19, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Hughston Clinic Pc — 112 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients113
Services billed 244 a service is one billed item, such as a visit, a test or a procedure
Average patient age73

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician.

  • Southwell Medical, A Campus Of Trmc Hospital · Adel, GA

Colleagues at Hughston Clinic PC

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 112 clinicians in the practice; 12 are shown here.

Other providers in Valdosta