Teresa L Roberts, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

71008269A Issued in IN

Practice address

909 E State Blvd
Fort Wayne, IN 46805

Phone

(260) 481-2700

Fax

(260) 481-2709

NPI assigned

Jun 29, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Teresa L Bush Former name

Electronic endpoints 3

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Park Center IncGroup PAC ID 5991794794, 47 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

83.53 of 100Reported as group

Quality

70

Promoting interoperability

100

Improvement activities

40

Cost

75.11

Merit-based Incentive Payment System (MIPS)

Final score

91.37 of 100Reported as group

Quality

80.38

Promoting interoperability

100

Improvement activities

40

Cost

74.18

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: troberts190759@direct.parkviewexchange.com

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.

• Park Center Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fort Wayne, IN
  • NPI 1306897004
  Medicare reassignment Care Compare group NPD
• Parkview Health System Inc

  dba Parkview Physicians Group

  • Family Medicine Physician
  • Fort Wayne, IN
  • NPI 1932130952
  Medicare reassignment NPD
• Park Center Inc

  • Psychiatric Hospital
  • Fort Wayne, IN
  • NPI 1457772402
  NPD
• Parkview Health System, Inc.

  dba Parkview Physicians Group

  • Internal Medicine Physician
  • Fort Wayne, IN
  • NPI 1952411233

  Psychiatric/Mental Health

  NPD

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

{
    "created_epoch": "1309305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1184911158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 E STATE BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468053404",
            "telephone_number": "260-481-2700",
            "fax_number": "260-481-2709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 E STATE BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46805",
            "telephone_number": "260-481-2700",
            "fax_number": "260-481-2709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "TERESA",
        "middle_name": "L",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-29",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "IN",
            "license": "28195388A",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "71008269A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "troberts190759@Direct.Parkviewexchange.com",
            "affiliation": "N",
            "address_1": "909 E State Blvd",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46805",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "909 E State Blvd",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46805",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "909 E State Blvd",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TERESA",
            "last_name": "BUSH",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michaela K Roberts
• Mont R Roberts, DO
• Nicole Roberts
• Rachel Roberts, RN
• Rachel E Roberts, LCSW
• Tiffany Roberts, SLP
• Zachary L Roberts, PHARMD
• Ellen L Robertson, FNP
• Randolph Harlen Robertson, MD
• Roy W Robertson, MD

• Psychiatric/Mental Health Nurse Practitioner in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.