Organization Active NPI

Michael P Roberts MD PA

  • Internal Medicine Physician
  • Niceville, FL
National Provider Identifier
1093971061
Registry record updated Mar 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MICHAEL P ROBERTS MD PA
Practice address
1001 College Blvd W Ste D
Niceville, FL 32578-1049
Phone
(850) 389-8333
Fax
(850) 279-6031
NPI assigned
Jul 30, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2026

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

Authorized official

Name
Michael Patrick Roberts, MDNPI 1972691368
Title
Owner
Phone
(850) 389-8333

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

1001 College Blvd W Ste D
Niceville, FL 32578-1049

Mailing address

1001 College Blvd W Ste D
Niceville, FL 32578-1049
Phone (850) 389-8333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080918000173 FL Part B Supplier - Clinic/Group Practice 8426125311 Receives reassigned benefits from 8 practitioners
Practice locations: Crestview, FL; Niceville, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D1091567Michael P Roberts MD PA1001 W College Blvd, Niceville, FL 32578Certificate of waiverNov 4, 2026

National Provider Directory

National Provider Directory

Locations

1001 College Blvd W
Ste D
Niceville, FL 32578
Phone (850) 389-8333

1001 College Blvd W
Niceville, FL 32578
Phone (850) 678-6735

1001 College Blvd W
Ste D
Niceville, FL 32578

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CCEJCA

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1217376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774224000000",
    "number": "1093971061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 COLLEGE BLVD W STE D",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325781049",
            "telephone_number": "850-389-8333",
            "fax_number": "850-279-6031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 COLLEGE BLVD W STE D",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325781049",
            "telephone_number": "850-389-8333",
            "fax_number": "850-279-6031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL P ROBERTS MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-30",
        "last_updated": "2026-03-23",
        "certification_date": "2026-03-23",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-389-8333",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niceville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.