Miguel Eduardo Roberts, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

102685 Issued in NC

Practice address

Perry Point VA Medical Center
Building 364, RM C108
Perry Point, MD 21902

Phone

(410) 642-2411

NPI assigned

Feb 7, 2007

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

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Kennedy Krieger Associates

  • Pediatrics Physician
  • Baltimore, MD
  • NPI 1871515783
  Medicare reassignment NPD
• Kennedy Krieger Associates

  • Pediatrics Physician
  • Middle River, MD
  • NPI 1841009842
  NPD

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073653044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1004 HICKAM RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212203700",
            "telephone_number": "410-642-2411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PERRY POINT VA MEDICAL CENTER",
            "address_2": "BUILDING 364, RM C108",
            "city": "PERRY POINT",
            "state": "MD",
            "postal_code": "21902",
            "telephone_number": "410-642-2411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "MIGUEL",
        "middle_name": "EDUARDO",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "102685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chekana Reid, LCSW-C
• Barbara Jean Rementer, RN, CSP, PHD,
• Christy Nicole Reyes, LCSW-C
• John Robert Richardson, MS, D.MIN.
• Elizabeth Cherry Roberts, LCSW-C
• Stephen Rose
• Doreen Carole Rupp, LSW
• Ellen Susan Russo, APRN,BC
• Kristyn Sanders
• Melecia Almonte Santos, M.D.

• Clinical Psychologist in Perry Point, MD
• Providers in Perry Point, MD by specialty
• Clinical Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.