Ammon Roberts, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MRO-1840 Issued in ID

Practice address

777 N Raymond St
Boise, ID 83704-9251

Phone

(208) 514-2500

Fax

(208) 375-2217

NPI assigned

May 1, 2019

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

Medicare fee-for-service enrollment

Enrolled in ID

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

Specialty

Family Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Alliance Medical Group LLCGroup PAC ID 3971544685, 132 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• First Choice Home Care Home health agency, Boise, ID, CCN 137108
• St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006
• Saint Alphonsus Regional Medical Center Hospital, Boise, ID, CCN 130007

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ammon.roberts@phmg.eclinicaldirectplus.com

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.

• Alliance Medical Group, LLC

  • Family Medicine Physician
  • Garden City, ID
  • NPI 1568413920
  Medicare reassignment Care Compare group NPD
• Alliance Medical Group, LLC

  • Family Medicine Physician
  • Boise, ID
  • NPI 1487326203
  NPD

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

• First Choice Home Care, Inc.

  • Home Health Agency
  • Boise, ID
  • NPI 1952305286
  Care Compare affiliation
• Saint Alphonsus Regional Medical Center Inc

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1184155426
  Care Compare affiliation
• Saint Alphonsus Regional Medical Center Inc

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1457414948
  Care Compare affiliation
• Saint Alphonsus Regional Medical Center Inc

  • Psychiatric Hospital Unit
  • Boise, ID
  • NPI 1770687857
  Care Compare affiliation
• Saint Alphonsus Regional Medical Center Inc

  • Family Medicine Physician
  • Caldwell, ID
  • NPI 1861676298

  Hospital

  Care Compare affiliation
• Saint Alphonsus Regional Medical Center Inc

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1992736649
  Care Compare affiliation
• St Lukes Regional Medical Center

  • Ambulance
  • Boise, ID
  • NPI 1518115195

  Hospital

  Care Compare affiliation
• St Lukes Regional Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  Care Compare affiliation

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

{
    "created_epoch": "1556668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556668800000",
    "number": "1225693666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 N RAYMOND ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049251",
            "telephone_number": "208-514-2500",
            "fax_number": "208-375-2217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 N RAYMOND ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049251",
            "telephone_number": "208-514-2500",
            "fax_number": "208-375-2217"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 E Elm St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Caldwell",
            "state": "ID",
            "postal_code": "836054858",
            "country_code": "US",
            "telephone_number": "208-459-7415",
            "fax_number": "208-302-7188",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "AMMON",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-01",
        "last_updated": "2019-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "MRO-1840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert O Stevens DMD, PA
• Robert Sanders DC PLLC
• Roberto a. Negron, M.D., P.C.
• Mackenna Ann-Maree Roberts-Wilson, BS
• Aileen R Roberts, MS, LPC, NCC
• Amy Lynn Roberts, LCSW
• Denton R Roberts, MD
• Derek Wasec Roberts, LMT
• Krista Richelle Roberts
• Kyle Roberts, PHARM.D.

• Family Medicine Physician in Boise, ID
• Providers in Boise, ID by specialty
• Family Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2019; 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.