Active NPI
John E Roberts III, M.D.
- Colon & Rectal Surgery Physician
- Fort Lauderdale, FL
National Provider Identifier
1124042247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Colon & Rectal Surgery Physician
- License
- 0068639
- Practice address
- 5700 N Federal Hwy
Suite One
Fort Lauderdale, FL 33308-2600 - Phone
- (954) 491-6400
- Fax
- (954) 771-8835
- NPI assigned
- Jul 26, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Colon & Rectal Surgery Physician | 208C00000X | 0068639 | FL | Primary |
Addresses
Primary practice location
5700 N Federal Hwy
Suite One
Fort Lauderdale, FL 33308-2600
Mailing address
5700 N Federal Hwy
Suite One
Fort Lauderdale, FL 33308-2600
Phone (954) 491-6400
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 020031374 | Other | FL | RAILROAD MEDICARE |
| 250732300 | Medicaid | FL | |
| 20342 | Other | FL | NEIGHBORHOOD HEALTH PARTN |
| 27794 | Other | FL | BLUE CROSS BLUE SHIELD |
| 246691 | Other | FL | AVMED |
| 093066 | Other | FL | CIGNA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0068639 | FL | MD | Colon & Rectal Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1279238400000",
"number": "1124042247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5700 N FEDERAL HWY",
"address_2": "SUITE ONE",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333082600",
"telephone_number": "954-491-6400",
"fax_number": "954-771-8835"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5700 N FEDERAL HWY",
"address_2": "SUITE ONE",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333082600",
"telephone_number": "954-491-6400",
"fax_number": "954-771-8835"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "JOHN",
"middle_name": "E",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-26",
"last_updated": "2010-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "208C00000X",
"taxonomy_group": "",
"desc": "Colon & Rectal Surgery",
"state": "FL",
"license": "0068639",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "020031374",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "250732300",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEIGHBORHOOD HEALTH PARTN",
"identifier": "20342",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "27794",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AVMED",
"identifier": "246691",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "093066",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Lauderdale, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.