Individual provider Active NPI

Brian M Roebuck, M.D.

  • Family Medicine Physician
  • Brooksville, FL
National Provider Identifier
1164456059
Registry record updated Nov 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME46566 Issued in FL
Practice address
11329 Cortez Blvd
Brooksville, FL 34613-5407
Phone
(352) 596-5052
Fax
(352) 596-5244
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME46566 FL Primary

Addresses

Primary practice location

11329 Cortez Blvd
Brooksville, FL 34613-5407

Mailing address

11329 Cortez Blvd
Brooksville, FL 34613-5407
Phone (352) 596-5052

Other identifiers 2

IdentifierTypeStateIssuer
51266ZOtherFLBCBS
016216800MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address brian.roebuck.1@4692.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20101108001033 FL Practitioner - Family Practice 9739223421 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wayne State University School of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tampa General Medical Group IncGroup PAC ID 7416253828, 353 clinicians

Practice addresses (Care Compare)

8425 Northcliffe Blvd
Suite 112
Spring Hill, FL 34606-1107
Phone (352) 686-2360

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa General Hospital Current Accepting new patients
Tampa General Medical Group Inc Family Medicine CurrentSince Dec 1, 2023 Accepting new patients
Tampa General Medical Group Inc CurrentSince Dec 1, 2023 Accepting new patients
Good Shepherd Medical Clinic PA Current Accepting new patients
Tampa General Medical Group Inc Current Accepting new patients
Tampa General Medical Group Inc Family Medicine Past Accepting new patients

Locations

8425 Northcliffe Blvd
Ste 109
Spring Hill, FL 34606
Phone (352) 596-9550

8425 Northcliffe Blvd
Ste 112
Spring Hill, FL 34606
Phone (352) 686-2360

8425 Northcliffe Blvd
Ste 108
Spring Hill, FL 34606
Phone (352) 597-2501

8425 Northcliffe Blvd
Ste 101
Spring Hill, FL 34606
Phone (352) 576-5041

8425 Northcliffe Blvd
Ste 111
Spring Hill, FL 34606
Phone (352) 686-2360

2433 Country Place Blvd
Trinity, FL 34655
Phone (813) 844-8200

Interoperability endpoints

  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: broebuck300940@direct.tgh.org

Organizations & group practices 6

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 4

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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1164456059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11329 CORTEZ BLVD",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "346135407",
            "telephone_number": "352-596-5052",
            "fax_number": "352-596-5244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11329 CORTEZ BLVD",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "346135407",
            "telephone_number": "352-596-5052",
            "fax_number": "352-596-5244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROEBUCK",
        "first_name": "BRIAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME46566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51266Z",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016216800",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brian.roebuck.1@4692.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR Direct Address",
            "address_1": "8425 Northcliffe Blvd Ste 108",
            "city": "Spring Hill",
            "state": "FL",
            "country_code": "US",
            "postal_code": "346061107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brooksville, FL

Sources for this page

Verify at the official NPI Registry.