Individual provider Active NPI

Paul Roberts, DO

  • Infectious Disease Physician
  • Hialeah, FL
National Provider Identifier
1104357946
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
OS16413 Issued in FL
Practice address
2001 W 68TH St
Suite 202
Hialeah, FL 33016-1801
Phone
(305) 364-2107
NPI assigned
Mar 23, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X OS16413 VA
Student in an Organized Health Care Education/Training Program 390200000X
Infectious Disease Physician 207RI0200X OS16413 FL Primary

Addresses

Primary practice location

2001 W 68TH St
Suite 202
Hialeah, FL 33016-1801

Mailing address

PO Box 160057
Miami, FL 33116-0057
Phone (786) 358-4443

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220811002160 FL Practitioner - Infectious Disease 6507135951 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Nova Southeastern College of Osteo Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PL Roberts Id LLCGroup PAC ID 1658818299, 4 clinicians

Practice addresses (Care Compare)

2001 W 66TH St
Hialeah, FL 33016-1801
Phone (786) 437-3397

Hospital & facility affiliations

  • Palmetto General Hospital Hospital, Hialeah, FL, CCN 100187

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS16413FLMDInfectious Disease Physician
OS16413VAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
PL Roberts Id LLC Infectious Disease CurrentSince Aug 1, 2024 Accepting new patients

Locations

2387 W 68th St
Ste 401
Hialeah, FL 33016
Phone (305) 325-8588

2001 W 68th St
Miami Lakes, FL 33016
Phone (305) 364-2151

Organizations & group practices 1

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": "1490227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1104357946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 160057",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331160057",
            "telephone_number": "786-358-4443",
            "fax_number": "786-685-2059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 W 68TH ST",
            "address_2": "SUITE 202",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330161801",
            "telephone_number": "305-364-2107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "PAUL",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-23",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "OS16413",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "FL",
            "license": "OS16413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.