Anthony Robertson, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601008569 Issued in MI

Practice address

1401 W North St
Jackson, MI 49202-3135

Phone

(517) 205-2555

Fax

(517) 205-0117

NPI assigned

Feb 5, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

W. a. Foote Memorial Hospital, Inc.Group PAC ID 0244136067, 476 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Henry Ford Allegiance Health Hospital, Jackson, MI, CCN 230092

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: arobertson501738@direct.hfhs.org

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.

• Wa Foote Memorial Hospital, Inc

  • Nurse Practitioner
  • Jackson, MI
  • NPI 1629000708
  Medicare reassignment Care Compare group
• W.a. Foote Memorial Hospital, Inc

  • Physician Assistant
  • Jackson, MI
  • NPI 1538606348
  NPD
• W.a. Foote Memorial Hospital, Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • Jackson, MI
  • NPI 1790222651
  NPD

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

• W.a. Foote Memorial Hospital

  • General Acute Care Hospital
  • Jackson, MI
  • NPI 1053403402
  Care Compare affiliation

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

{
    "created_epoch": "1517788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612224000000",
    "number": "1225537376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 W NORTH ST",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492023135",
            "telephone_number": "517-205-2555",
            "fax_number": "517-205-0117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 W NORTH ST",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492023135",
            "telephone_number": "517-205-2555",
            "fax_number": "517-205-0117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "ANTHONY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-05",
        "last_updated": "2021-02-02",
        "certification_date": "2021-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601008569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "arobertson501738@direct.hfhs.org",
            "affiliation": "N",
            "address_1": "1401 W North St",
            "city": "Jackson",
            "state": "MI",
            "country_code": "US",
            "postal_code": "492023135",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Robert M Doane MD PC
• Robert N Israel, MD
• Heather Roberts
• Jeanie Roberts
• Tabitha Roberts, LLPC
• Robert Oscar Robertson, DO
• Todd A Robertson, DC
• Ciji Christina Robinson, M.D.
• Alexandra Marie Rockwell
• Lilly Rockwell

• Physician Assistant in Jackson, MI
• Providers in Jackson, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2021; 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.