Samuel Paul Roberts, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

10401 Issued in GA

Practice address

4150 Deputy Bill Cantrell Memorial Road
Suite 290
Cumming, GA 30040

Phone

(404) 446-0600

Fax

(404) 446-0601

NPI assigned

Mar 10, 2021

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 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

Merit-based Incentive Payment System (MIPS)

Final score

91.62 of 100Reported as apm

Quality

83.25

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Orthoatlanta, LLC

  • Orthopaedic Surgery Physician
  • Newnan, GA
  • NPI 1851937114
  Medicare reassignment
• Gi North PC

  • Gastroenterology Physician
  • Cumming, GA
  • NPI 1750689964
  NPD (past)
• Newco Gi LLC

  • Gastroenterology Physician
  • Cumming, GA
  • NPI 1073999066
  NPD (past)
• Orthoatlanta, LLC

  • Orthopaedic Surgery Physician
  • Aiken, SC
  • NPI 1427887157
  NPD (past)

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

{
    "created_epoch": "1615334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1285219477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 DEPUTY BILL CANTRELL MEMORIAL ROAD",
            "address_2": "SUITE 290",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "30040",
            "telephone_number": "404-446-0600",
            "fax_number": "404-446-0601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 DEPUTY BILL CANTRELL MEMORIAL ROAD",
            "address_2": "SUITE 290",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "30040",
            "telephone_number": "404-446-0600",
            "fax_number": "404-446-0601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "SAMUEL",
        "middle_name": "PAUL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-10",
        "last_updated": "2024-07-08",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "10401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Rives, PT, DPT
• Riyan Simone, LLC
• Heather Boss Roach, OT
• Carla Delle Roberts, M.D.
• Michael Roberts, OD
• Gretta Christine Robertson, MS-CCC-SLP
• Robin a. Brill, PHD,LLC
• Kahlilah Tramaine Robinson, OT
• Lisa V Robinson, DNP-FNP-C
• Skylar J Robinson

• Medical Physician Assistant in Cumming, GA
• Providers in Cumming, GA by specialty
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; 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.