NPIMap

Individual provider Active NPI

Jared Richard Roberts, DO

  • Vascular & Interventional Radiology Physician
  • Lewisberry, PA
National Provider Identifier
1124552245
Registry record updated May 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
OS022672 Issued in PA
Practice address
629D Lowther Rd
Lewisberry, PA 17339-9527
Phone
(717) 932-5200
NPI assigned
Apr 14, 2017
Last updated
May 9, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X OT018381 PA
Student in an Organized Health Care Education/Training Program 390200000X
Vascular & Interventional Radiology Physician 2085R0204X OS022672 PA Primary

Addresses

Primary practice location

629D Lowther Rd
Lewisberry, PA 17339-9527

Mailing address

629D Lowther Rd
Lewisberry, PA 17339-9527
Phone (717) 932-5200

Other practice location 1

500 University Dr
Hershey, PA 17033-2360
Phone (717) 531-4935

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230607000908 PA Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 0840657854 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional RadiologyAlso: Diagnostic Radiology
Education
At Still Un of HLTH Sciences, Col of Osteo Med, Mesa, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

503 N 21St St
Camp Hill, PA 17011-2204
Phone (717) 972-4301

629 D Lowther Rd
Lewisberry, PA 17339-9527
Phone (717) 932-5200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.93 of 100Reported as group
Quality
90.59
Improvement activities
40
Cost
57.01

Merit-based Incentive Payment System (MIPS)

Final score
82.85 of 100Reported as group
Quality
65.84
Promoting interoperability
100
Improvement activities
40
Cost
77

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS022672PAMDVascular & Interventional Radiology Physician
OT018381PAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Penn State Health Medical Group, LLC CurrentSince Aug 1, 2023 Accepting new patients
Quantum Imaging & Therapeutic Associates Inc Vascular & Interventional Radiology CurrentSince Jul 1, 2023 Accepting new patients
Penn State Health Medical Group, LLC Current Accepting new patients

Locations

503 N 21st St
Camp Hill, PA 17011
Phone (717) 763-2461

51 Business Campus Way
Ste 100
Duncannon, PA 17020
Phone (717) 834-3280

1120 Cocoa Ave
Hershey, PA 17033
Phone (717) 533-4141

500 University Dr
Hershey, PA 17033
Phone (717) 531-8181

629D Lowther Rd
Lewisberry, PA 17339
Phone (717) 938-2765

Interoperability endpoints

  • Direct secure messaging: jroberts489710@wellspan.direct-ci.com

Organizations & group practices 3

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 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1492128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683590400000",
    "number": "1124552245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629D LOWTHER RD",
            "city": "LEWISBERRY",
            "state": "PA",
            "postal_code": "173399527",
            "telephone_number": "717-932-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629D LOWTHER RD",
            "city": "LEWISBERRY",
            "state": "PA",
            "postal_code": "173399527",
            "telephone_number": "717-932-5200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 University Dr",
            "address_purpose": "LOCATION",
            "city": "Hershey",
            "state": "PA",
            "postal_code": "170332360",
            "country_code": "US",
            "telephone_number": "717-531-4935",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "JARED",
        "middle_name": "RICHARD",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-14",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "OT018381",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "PA",
            "license": "OS022672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisberry, PA

Sources for this page

Verify at the official NPI Registry.