Individual provider Active NPI

Nathan Roberts, PA-C

  • Physician Assistant
  • Columbus, IN
National Provider Identifier
1114405438
Registry record updated Jul 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
100024878A Issued in IN
Practice address
2400 17TH St
Columbus, IN 47201-5351
Phone
(812) 379-4441
NPI assigned
Jul 30, 2018
Last updated
Jul 30, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 100024878A IN Primary

Addresses

Primary practice location

2400 17TH St
Columbus, IN 47201-5351

Mailing address

PO Box 3007
Columbus, IN 47202-3007
Phone (812) 379-4441

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, MN, WA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20180904002691 IN Practitioner - Physician Assistant 4688924186 Reassigns benefits to 1 organization
I20241121001942 MN Practitioner - Physician Assistant 4688924186 Reassigns benefits to 1 organization
I20260225003304 WA Practitioner - Physician Assistant 4688924186 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spokane Emergency Physicians PSGroup PAC ID 8527050731, 43 clinicians

Practice addresses (Care Compare)

101 W 8TH Ave
Spokane, WA 99204-2307
Phone (877) 346-2211

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.51 of 100Reported as group
Quality
95.35
Improvement activities
40
Cost
78.59

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
100024878AINMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Spokane Emergency Physicians, PS CurrentSince Jan 12, 2026 Accepting new patients
Medexpress Urgent Care Minnesota P.C. Past Accepting new patients

Locations

101 W 8th Ave
Spokane, WA 99204
Phone (509) 474-3181

Interoperability endpoints

  • Direct secure messaging: nroberts223866@ecommunitydirect.com

Organizations & group practices 4

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.

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": "1532908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532908800000",
    "number": "1114405438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3007",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472023007",
            "telephone_number": "812-379-4441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 17TH ST",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472015351",
            "telephone_number": "812-379-4441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "NATHAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-30",
        "last_updated": "2018-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "100024878A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, IN

Sources for this page

Verify at the official NPI Registry.