Judy Jennifer Roberts, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

OS9253 Issued in FL

Practice address

1055 Saxon Blvd
Orange City, FL 32763-8468

Phone

(386) 943-4522

NPI assigned

Jun 12, 2006

Last updated

Feb 1, 2008By the provider in NPPES

Sex

Female

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

Medicare fee-for-service enrollment

Enrolled in FL

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

Emergency Medicine

Education

Philadelphia College of Osteopathic Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency Medicine Professionals PAGroup PAC ID 0446244362, 20 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Daytona Beach Hospital, Daytona Beach, FL, CCN 100068
• Adventhealth New Smyrna Beach Hospital, New Smyrna Beach, FL, CCN 100014

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Emergency Medicine Professionals PA

  • Emergency Medicine Physician
  • Deland, FL
  • NPI 1205880853
  Medicare reassignment Care Compare group NPD
• Bay View Urgent Care LLC

  • Family Medicine Physician
  • New Smyrna Beach, FL
  • NPI 1386896991
  NPD (past)

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

• Memorial Health Systems Inc

  dba AdventHealth Daytona Beach

  • General Acute Care Hospital
  • Daytona Beach, FL
  • NPI 1063426823
  Care Compare affiliation
• Memorial Health Systems Inc

  dba AdventHealth Daytona Beach

  • Clinical Medical Laboratory
  • Daytona Beach, FL
  • NPI 1104696178

  Hospital

  Care Compare affiliation
• Southeast Volusia Healthcare Corporation

  dba AdventHealth New Smyrna Beach

  • General Acute Care Hospital
  • New Smyrna Beach, FL
  • NPI 1871977942
  Care Compare affiliation

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201824000000",
    "number": "1275575144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9430",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321209430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 SAXON BLVD",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638468",
            "telephone_number": "386-943-4522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "JUDY",
        "middle_name": "JENNIFER",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2008-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "OS9253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF FLORIDA",
            "identifier": "49661",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Rivetto, MA, BCBA
• Rizen Wellness Lounge LLC
• Robert Erdman, D.D.S.,P.a.
• Robert P. Collette MD PA
• Brooke Alison Roberts
• Taylor Roberts
• Charlene Trisha Robertson, M.D
• Emily Robinson, PA-C
• Jessica Robinson
• Kayla Robinson

• Emergency Medicine Physician in Orange City, FL
• Providers in Orange City, FL by specialty
• Emergency Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2008; 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.