NPIMap

Individual provider Active NPI

Leroy Roberts Jr., M.D.

  • Diagnostic Radiology Physician
  • Fayetteville, NC
National Provider Identifier
1073518254
Registry record updated Aug 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
30989 Issued in NC
Practice address
3186 Village Dr 201
Fayetteville, NC 28304-3979
Phone
(910) 486-5700
NPI assigned
Jun 15, 2005
Last updated
Aug 18, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology Physician 2085N0700X 30989 NC
Diagnostic Radiology Physician 2085R0202X 30989 NC Primary

Addresses

Primary practice location

3186 Village Dr 201
Fayetteville, NC 28304-3979

Mailing address

3186 Village Dr 201
Fayetteville, NC 28304-3979
Phone (910) 486-5700

Other identifiers 1

IdentifierTypeStateIssuer
8972464MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060222000026 NC Practitioner - Diagnostic RadiologyPractitioner - Neurology 3274549712 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Neurology
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scotland Memorial Hospital, IncGroup PAC ID 0648208504, 259 clinicians

Practice addresses (Care Compare)

4420 Turnberry Cir
Durham, NC 27712-9466
Phone (469) 757-1042

500 Jefferson St
Whiteville, NC 28472-3634
Phone (910) 642-8011

500 Lauchwood Dr
Laurinburg, NC 28352-5501
Phone (910) 610-4172

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.33 of 100Reported as group
Quality
73.83
Improvement activities
40
Cost
93.42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
30989NCMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Radiology P a Diagnostic Radiology CurrentSince Sep 19, 1988 Accepting new patients
Medical Imaging Center, LLC CurrentSince May 16, 2009 Accepting new patients
Columbus Regional Healthcare System CurrentSince Jul 5, 2025 Accepting new patients
Pinnacle Health Services of North Carolina, LLC Diagnostic Radiology CurrentSince Nov 1, 2024 Accepting new patients
Columbus Regional Healthcare System CurrentSince Jul 5, 2025 Accepting new patients
Pinnacle Health Services of North Carolina LLC Diagnostic Radiology CurrentSince Nov 1, 2024 Accepting new patients
Scotland Memorial Hospital Inc CurrentSince Oct 1, 2024 Accepting new patients
Scotland Memorial Hospital Inc Diagnostic Radiology CurrentSince Oct 1, 2024 Accepting new patients
Pinnacle Health Services of North Carolina, LLC Diagnostic Radiology CurrentSince Nov 1, 2024 Accepting new patients
Pinnacle Health Services of North Carolina, LLC Diagnostic Radiology CurrentSince Nov 1, 2024 Accepting new patients
Brier Creek Imaging, LLC Diagnostic Radiology CurrentSince Nov 1, 2024 Accepting new patients
Cumberland County Hospital System Inc Diagnostic Radiology CurrentSince Jun 1, 2025 Accepting new patients
National Imaging Affiliates of Fayetteville, Inc Past Accepting new patients
Bladen Healthcare LLC Past Accepting new patients

Locations

501 S Poplar St
Elizabethtown, NC 28337
Phone (910) 862-4043

3186 Village Dr
Ste 101
Fayetteville, NC 28304
Phone (910) 221-2500

3186 Village Dr
Ste 201
Fayetteville, NC 28304
Phone 9104865700104

500 Lauchwood Dr
Laurinburg, NC 28352
Phone (856) 848-3227

500 Jefferson St
Whiteville, NC 28472
Phone (910) 642-1776

Organizations & group practices 14

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

View all 14

Hospital & facility affiliations 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439856000000",
    "number": "1073518254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3186 VILLAGE DR 201",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043979",
            "telephone_number": "910-486-5700",
            "fax_number": "910-486-5950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3186 VILLAGE DR 201",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043979",
            "telephone_number": "910-486-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "LEROY",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-15",
        "last_updated": "2015-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "NC",
            "license": "30989",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "30989",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8972464",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.