Andrew L Roberts, D.O.
Individual provider Active NPI Family Medicine Physician · Basin, WY
NPI 1164521977 · NPPES record last updated Mar 7, 2023
Key facts
- NPI
- 1164521977
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 7406A (WY)
- Practice address
- 388 US Highway 20 S
Basin, WY 82410-8902 - Phone
- (307) 568-3311
- Fax
- (307) 568-2139
- NPI assigned
- Sep 21, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of North Texas HSC, College of Osteopathic Med, 2002
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Sidney Health Center
Practice addresses (Care Compare)
216 14TH Ave SW
Sidney, MT 59270-3519
Phone (406) 488-2036
Hospital & facility affiliations
- Sidney Health Center
- Intermountain Health St Vincent Regional Hospital
- Sidney Health Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in WY, MT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070430000189 | WY | Practitioner - Family Practice |
8325144801 | Reassigns benefits to 1 organization |
| I20151111001909 | MT | Practitioner - Family Practice | 8325144801 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7406A | WY | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rural Physicians Group-Pannu PLLC | Family Medicine | Current |
Accepting new patients |
| Sidney Health Center | Current |
Accepting new patients | |
| Sidney Health Center | Current |
Accepting new patients | |
| Sidney Health Center | Current | Accepting new patients | |
| Sidney Health Center | Current | Accepting new patients | |
| Bitter Creek Inpatient Services LLC | Past | Accepting new patients | |
| Lander Valley Physician Practices, LLC | Past | Accepting new patients | |
| Sidney Health Center | Past | Accepting new patients |
Locations
5575 Dtc Pkwy
Ste 225
Greenwood Village, CO 80111
216 14th Ave SW
Sidney, MT 59270
Phone (406) 488-2100
214 14th Ave SW
Sidney, MT 59270
Phone (406) 488-2100
2221 Elm St
Rawlins, WY 82301
Phone (307) 324-2221
400 S 15th St
Worland, WY 82401
Phone (307) 347-3221
Interoperability endpoints
- aroberts2@yourcarecommunity.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 7406A | WY | Yes |
Addresses
Primary practice location
388 US Highway 20 S
Basin, WY 82410-8902
Mailing address
388 US Highway 20 S
Basin, WY 82410-8902
Phone (307) 568-3311
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7406A | Other | WY | STATE LICENSE |
Other providers in Basin, WY
- Rosemary Newton
- Julie A Oster
- David Sherwin Peterson
- Enrika Rain Joy Potter
- Emily Pustelnik
- Carissa Rohrbach
- Jacob R Shaw
- Jesi Skretteberg
- Christine Mae Smith
- South Big Horn County Hospital District
All providers in Basin, WY · Family Medicine Physician in Wyoming
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.