Individual provider Active NPI

Michael D Robertson, M.D.

  • Internal Medicine Physician
  • Lubbock, TX
National Provider Identifier
1124067947
Registry record updated Dec 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G3735 Issued in TX
Practice address
3801 50TH St
Lubbock, TX 79413-3859
Phone
(806) 771-5550
Fax
(806) 771-5544
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G3735 TX Primary

Addresses

Primary practice location

3801 50TH St
Lubbock, TX 79413-3859

Mailing address

PO Box 6248
Lubbock, TX 79493-6248
Phone (806) 771-5550

Other identifiers 1

IdentifierTypeStateIssuer
132160604MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20100405000054 TX Practitioner - Internal Medicine 4789597626 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Medical GroupGroup PAC ID 6901889393, 228 clinicians

Practice addresses (Care Compare)

2215 Nashville Ave
Lubbock, TX 79410-1105
Phone (806) 725-5844

3801 50TH St
Lubbock, TX 79413-3807
Phone (806) 725-7700

611 N Frankford Ave
Lubbock, TX 79416-1545
Phone (806) 725-5480

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group CurrentSince Feb 1, 2014 Accepting new patients
Covenant Medical Group Internal Medicine CurrentSince Feb 1, 2014 Accepting new patients

Locations

3801 50th St
Lubbock, TX 79413
Phone (806) 771-5500

2215 Nashville Ave
Lubbock, TX 79410
Phone (806) 725-5228

3506 21st St
Ste 202
Lubbock, TX 79410
Phone (806) 725-4810

Interoperability endpoints

  • Direct secure messaging: michael.robertson@direct.myteamcare.com

Organizations & group practices 2

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 3

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261094400000",
    "number": "1124067947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6248",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794936248",
            "telephone_number": "806-771-5550",
            "fax_number": "806-771-5544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 50TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794133859",
            "telephone_number": "806-771-5550",
            "fax_number": "806-771-5544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2009-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "G3735",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "132160604",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.