Active NPI
Jonathan D Roebuck
- Rheumatology Physician
- Fort Gordon, GA
National Provider Identifier
1013011626
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rheumatology Physician
- License
- 78234
- Practice address
- Dwight David Eisenhower AMC
300 E Hospital Rd
Fort Gordon, GA 30905-0001 - Phone
- (706) 787-4154
- NPI assigned
- Sep 12, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rheumatology Physician | 207RR0500X | 78234 | GA | Primary |
| Rheumatology Physician | 207RR0500X | 59182 | MT |
Addresses
Primary practice location
Dwight David Eisenhower AMC
300 E Hospital Rd
Fort Gordon, GA 30905-0001
Mailing address
Dwight David Eisenhower AMC
300 E Hospital Rd
Fort Gordon, GA 30905-0001
Phone (706) 787-4154
Other practice location 1
Walter Reed Bethesda
8901 Rockville Pike
Bethesda, MD 20889-0001
Phone (301) 295-4512
Other practice location 2
708 Broadwater Ave
Billings, MT 59101-2710
Phone (406) 690-2002
Other names 1
- Jonathan Roebuck
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX, MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Rheumatology
- Education
- Georgetown University School of Medicine, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
100 Lake Traverse Dr
Sisseton, SD 57262-7046
Phone (605) 698-7606
24276 166TH Airport Rd
Eagle Butte, SD 57625-1022
Phone 60596477240515
400 Soldier Creek Dr
Rosebud, SD 57570-8502
Phone (918) 457-8945
PO Box
Suite 1012
Eagle Butte, SD 57625-1012
PO Box
Suite 400
Rosebud, SD 57570
Hospital & facility affiliations
- PHS Indian Hospital at Rosebud
- Eagle Butte Indian Health Service Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.52 of 100
- Quality
- 68.64
- Promoting interoperability
- 91
- Improvement activities
- 40
- Cost
- 86.31
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 59182 | MT | MD | Rheumatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Quentin N Burdick Comprehensive Health Care Facility | Current | Accepting new patients | |
| Woodrow Wilson Keeble Memorial Health Care Center | Current | Accepting new patients | |
| Rosebud Indian Health Service | Current | Accepting new patients | |
| Rosebud Indian Health Service | Current | Accepting new patients | |
| Eagle Butte Indian Health Service Hospital | Current | Accepting new patients |
Locations
1300 Hospital Loop
Belcourt, ND 58316
4100 W 150th St
#3
Cleveland, OH 44135
100 Lake Traverse Dr
Sisseton, SD 57262
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/IBEFCA/Endpoint/IBEFCA
- clinical@aocmt.directbygreenway.com
Organizations & group practices 6
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.
-
- Public Health or Welfare Agency
- Eagle Butte, SD
- NPI 1558395848
TX
-
- Rural Acute Care Hospital
- Belcourt, ND
- NPI 1952346934
TX
-
- Critical Access Hospital
- Cloquet, MN
- NPI 1003869082
-
- Ambulatory Surgical Clinic/Center
- Rosebud, SD
- NPI 1790955128
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Rosebud, SD
- NPI 1427419282
-
- Public Health or Welfare Agency
- Eagle Butte, SD
- NPI 1558395848
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698796800000",
"number": "1013011626",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "DWIGHT DAVID EISENHOWER AMC",
"address_2": "300 E HOSPITAL RD",
"city": "FORT GORDON",
"state": "GA",
"postal_code": "309050001",
"telephone_number": "706-787-4154"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "DWIGHT DAVID EISENHOWER AMC",
"address_2": "300 E HOSPITAL RD",
"city": "FORT GORDON",
"state": "GA",
"postal_code": "309050001",
"telephone_number": "706-787-4154"
}
],
"practiceLocations": [
{
"address_1": "Walter Reed Bethesda",
"address_2": "8901 Rockville Pike",
"address_purpose": "LOCATION",
"city": "Bethesda",
"state": "MD",
"postal_code": "208890001",
"country_code": "US",
"telephone_number": "301-295-4512",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "708 Broadwater Ave",
"address_purpose": "LOCATION",
"city": "Billings",
"state": "MT",
"postal_code": "591012710",
"country_code": "US",
"telephone_number": "406-690-2002",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROEBUCK",
"first_name": "JONATHAN",
"middle_name": "D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-12",
"last_updated": "2023-11-01",
"certification_date": "2023-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "207RR0500X",
"taxonomy_group": "",
"desc": "Internal Medicine, Rheumatology",
"state": "GA",
"license": "78234",
"primary": true
},
{
"code": "207RR0500X",
"taxonomy_group": "",
"desc": "Internal Medicine, Rheumatology",
"state": "MT",
"license": "59182",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JONATHAN",
"last_name": "ROEBUCK",
"credential": "MD",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Fort Gordon, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 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.