Roger D Roberts, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4019 Issued in AR

Practice address

745 E Joyce Blvd Ste 124
Fayetteville, AR 72703-6391

Phone

(795) 829-1194

NPI assigned

Mar 14, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dang Eyecare and Associates, P.a.Group PAC ID 2365599610, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9
• devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dang Eyecare & Associates, P.a.

  • Optometrist
  • Fort Smith, AR
  • NPI 1801038195
  Medicare reassignment Care Compare group NPD
• Geriatric Vision Care LLC

  • Ophthalmology Physician
  • Westmont, IL
  • NPI 1497830673

  Optometrist

  NPD (past)
• James M Noth M.D. , LTD

  • Specialist
  • Westmont, IL
  • NPI 1922219450
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672790400000",
    "number": "1003885138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 E JOYCE BLVD STE 124",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727036391",
            "telephone_number": "479-582-9119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 E JOYCE BLVD STE 124",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727036391",
            "telephone_number": "795-829-1194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "ROGER",
        "middle_name": "D",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "4019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046007739",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charissa D Roberts, PTA
• Emma Roberts
• Kent Edward Roberts
• Leslie Roberts, LPC
• Patricia Ann Roberts, NP
• Anna Taylor Robertson, DO
• Kellie Nichole Robertson, MSN, NP-C
• Logan Robertson, PLMSW
• Brianna F Robinson
• Cerah Robinson, SLP

• Optometrist in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Optometrist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.