Individual provider Active NPI

Mark N. Roberts, D.O.

  • Emergency Medicine Physician
  • Milwaukie, OR
National Provider Identifier
1154485514
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
DO18206 Issued in OR
Practice address
10150 SE 32ND Ave
Milwaukie, OR 97222-6516
Phone
(503) 297-6334
Fax
(503) 297-2360
NPI assigned
Dec 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X DO18206 OR Primary

Addresses

Primary practice location

10150 SE 32ND Ave
Milwaukie, OR 97222-6516

Mailing address

9340 SW Barnes Rd
Suite 202
Portland, OR 97225-6623
Phone (503) 297-6334

Other identifiers 1

IdentifierTypeStateIssuer
062695MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20040405000775 OR Practitioner - Internal MedicinePractitioner - Emergency Medicine 8729071907 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Emergency Medicine
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health and Services OregonGroup PAC ID 6103728753, 52 clinicians

Practice addresses (Care Compare)

10150 SE 32ND Ave
Milwaukie, OR 97222-6516
Phone (503) 513-8300

Hospital & facility affiliations

  • Providence Milwaukie Hospital Hospital, Milwaukie, OR, CCN 380082

Merit-based Incentive Payment System (MIPS)

Final score
94.39 of 100Reported as group
Quality
83
Promoting interoperability
100
Improvement activities
40
Cost
89.32

Merit-based Incentive Payment System (MIPS)

Final score
95 of 100Reported as group
Quality
83.34
Promoting interoperability
100
Improvement activities
40
Cost
100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO18206ORMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon Emergency Medicine CurrentSince Jun 1, 2002 Accepting new patients
Providence Health & Services Oregon Emergency Medicine Current Accepting new patients
Providence Health & Services Oregon CurrentSince Jun 1, 2002 Accepting new patients
Integrated Joint Specialists LLC Past Accepting new patients

Locations

810 12th St
Hood River, OR 97031
Phone (541) 386-3911

10150 SE 32nd Ave
Portland, OR 97222
Phone (503) 215-4202

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 and National Provider Directory roles.

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": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154485514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9340 SW BARNES RD",
            "address_2": "SUITE 202",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256623",
            "telephone_number": "503-297-6334",
            "fax_number": "503-297-2360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10150 SE 32ND AVE",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972226516",
            "telephone_number": "503-297-6334",
            "fax_number": "503-297-2360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "MARK",
        "middle_name": "N.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "DO18206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "062695",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukie, OR

Sources for this page

Verify at the official NPI Registry.