Individual provider Active NPI

Kenneth B Roberts, MD

  • Radiation Oncology Physician
  • New Haven, CT
National Provider Identifier
1275522047
Registry record updated Mar 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
032210 Issued in CT
Practice address
15 York St
Hunter Building, 1St Floor
New Haven, CT 06510-3221
Phone
(203) 688-1861
Fax
(203) 785-4622
NPI assigned
Oct 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 032210 CT Primary

Addresses

Primary practice location

15 York St
Hunter Building, 1St Floor
New Haven, CT 06510-3221

Mailing address

15 York St
Hunter Building, 1St Floor
New Haven, CT 06510-3221
Phone (203) 688-1861

Other identifiers 1

IdentifierTypeStateIssuer
001322106MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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

Enrollment IDStateProvider typePAC IDDetails
I20101013000418 CT Practitioner - Radiation Oncology 0840482501 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Duke University School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians

Practice addresses (Care Compare)

2080 Whitney Ave
Suite 100
Hamden, CT 06518-3603
Phone (203) 867-5617

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.36 of 100Reported as group
Quality
77.36
Promoting interoperability
100
Improvement activities
40
Cost
74.27

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
032210CTMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Medical Group Inc Radiation Oncology CurrentSince Apr 15, 2019 Accepting new patients
Yale University CurrentSince Feb 25, 1992 Accepting new patients
Yale University CurrentSince Feb 25, 1992 Accepting new patients

Locations

2080 Whitney Ave
Ste 100
Hamden, CT 06518
Phone (203) 987-3303

2080 Whitney Ave
Hamden, CT 06518
Phone (203) 789-3434

300 George St
Fl 6
New Haven, CT 06511
Phone (203) 785-6610

15 York St
Bldg 1ST
New Haven, CT 06510
Phone (203) 688-4344

175 Sherman Ave
New Haven, CT 06511
Phone (203) 562-5115

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

Interoperability endpoints

  • Direct secure messaging: kroberts8277@direct.ynhh.org

Organizations & group practices 4

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301529600000",
    "number": "1275522047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 YORK ST",
            "address_2": "HUNTER BUILDING, 1ST FLOOR",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103221",
            "telephone_number": "203-688-1861",
            "fax_number": "203-785-4622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 YORK ST",
            "address_2": "HUNTER BUILDING, 1ST FLOOR",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103221",
            "telephone_number": "203-688-1861",
            "fax_number": "203-785-4622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "KENNETH",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-14",
        "last_updated": "2011-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "CT",
            "license": "032210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001322106",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.