Individual provider Active NPI

Angela Kay Roberts, NP

  • Acute Care Nurse Practitioner
  • Kalamazoo, MI
National Provider Identifier
1063995173
Registry record updated Sep 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
4704239657 Issued in MI
Practice address
1521 Gull Rd
Kalamazoo, MI 49048-1640
Phone
(269) 226-7000
NPI assigned
Sep 13, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LA2100X 4704239657 MI Primary

Addresses

Primary practice location

1521 Gull Rd
Kalamazoo, MI 49048-1640

Mailing address

1521 Gull Rd
Kalamazoo, MI 49048-1640
Phone (269) 226-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181211002912 MI Practitioner - Nurse Practitioner 3375887797 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ascension Medical Group PromedGroup PAC ID 7315856077, 255 clinicians

Practice addresses (Care Compare)

1521 Gull Rd
Kalamazoo, MI 49048-1640
Phone (269) 226-5165

Hospital & facility affiliations

  • Borgess Medical Center Hospital, Kalamazoo, MI, CCN 230117

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group Promed Acute Care CurrentSince Dec 2, 2018 Accepting new patients
Sound Inpatient Physicians-Michigan, PLLC Single Specialty CurrentSince May 11, 2024 Accepting new patients
Promed Healthcare CurrentSince Dec 2, 2018 Accepting new patients
Sound Inpatient Physicians - Michigan, PLLC CurrentSince May 11, 2024 Accepting new patients
Ascension Medical Group Promed Single Specialty Current Accepting new patients

Locations

1521 Gull Rd
Kalamazoo, MI 49048
Phone (269) 226-5165

2520 Robert Jones Way
Kalamazoo, MI 49009
Phone (269) 375-0400

580 W College Ave
Marquette, MI 49855
Phone (906) 225-3131

411 Naomi St
Plainwell, MI 49080
Phone (269) 685-0700

7901 Angling Rd
Portage, MI 49024
Phone (269) 324-8405

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1536796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536796800000",
    "number": "1063995173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1521 GULL RD",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481640",
            "telephone_number": "269-226-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 GULL RD",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481640",
            "telephone_number": "269-226-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "ANGELA",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-13",
        "last_updated": "2018-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MI",
            "license": "4704239657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.