Eric Daniel Roberts, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10002359A Issued in IN

Practice address

111 N Nappanee St
Elkhart, IN 46514

Phone

(574) 522-0265

NPI assigned

Nov 24, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Epiphany Dermatology of Georgia, LLCGroup PAC ID 6800798182, 22 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

88.74 of 100Reported as group

Quality

83.29

Promoting interoperability

100

Improvement activities

40

Cost

79.17

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: eric.roberts@epiphanyderm.emadirect.md

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.

• Epiphany Dermatology of Georgia, LLC

  • Dermatology Physician
  • Fayetteville, GA
  • NPI 1265544357
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1416787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541894400000",
    "number": "1235536939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N NAPPANEE ST",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465141957",
            "telephone_number": "574-522-0265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N NAPPANEE ST",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "46514",
            "telephone_number": "574-522-0265"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "431 Meadowlark St",
            "address_purpose": "LOCATION",
            "city": "Shaw AFB",
            "state": "SC",
            "postal_code": "291525019",
            "country_code": "US",
            "telephone_number": "803-895-6587",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "431 Meadowlark St",
            "address_purpose": "LOCATION",
            "city": "Shaw AFB",
            "state": "SC",
            "postal_code": "291525019",
            "country_code": "US",
            "telephone_number": "803-895-6587",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "ERIC",
        "middle_name": "DANIEL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-24",
        "last_updated": "2018-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10002359A",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Riverpointe Cardiovascular Laboratory, LLC
• Riverview Adult Day Center
• Gregory Alan Robbins, DDS, MSD
• Angel Lam Roberson, NP
• Daniel Martin Roberts, SA-C
• Jamila Ife Roberts, PTA
• Janelle R Roberts
• Victoria Roberts
• Alison Rae Robertson, D.D.S.
• Tina M Robertson, LCAC, LSW

• Physician Assistant in Elkhart, IN
• Providers in Elkhart, IN by specialty
• Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2018; 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.