Samuel H Roberts, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

1467 Issued in AZ

Practice address

4111 E Valley Auto Dr
Suite 209
Mesa, AZ 85206-4605

Phone

(480) 982-0922

Fax

(480) 539-2888

NPI assigned

Jul 21, 2006

Sex

Male

Sole proprietor

Yes

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 AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Kirkland Healthcare Systems, P.C.

  • Rehabilitation Chiropractor
  • Gilbert, AZ
  • NPI 1033314547

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492992000000",
    "number": "1114948957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5880",
            "city": "APACHE JUNCTION",
            "state": "AZ",
            "postal_code": "851780032",
            "telephone_number": "480-982-0922",
            "fax_number": "480-539-2888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4111 E VALLEY AUTO DR",
            "address_2": "SUITE 209",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064605",
            "telephone_number": "480-982-0922",
            "fax_number": "480-539-2888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "SAMUEL",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2017-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "1467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michele Lillian Roberts, PT, DPT
• Monica Roberts, PT
• Nancy Eileen Roberts, LCSW
• Rachel Gastala Roberts, OTR
• Russell Roberts, D.O.
• Alyssa Robertson, DPT
• Deborah K Robertson, N.P.
• Karyn F. Robertson, PA
• Sabrina Marguerite Robidoux, PMHNP
• Robinson Orthodontics

• Family Medicine Physician in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2017; 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.