Individual provider Active NPI

Marsha Roberts, M.D.

  • Diagnostic Radiology Physician
  • Walnut Creek, CA
National Provider Identifier
1285661090
Registry record updated Dec 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A55851 Issued in CA
Practice address
1601 Ygnacio Valley Rd
Walnut Creek, CA 94598-3122
Phone
(925) 296-7156
Fax
(925) 296-7174
NPI assigned
Jun 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A55851 CA Primary

Addresses

Primary practice location

1601 Ygnacio Valley Rd
Walnut Creek, CA 94598-3122

Mailing address

175 Lennon LN
Suite 100
Walnut Creek, CA 94598-2485
Phone (925) 296-1756

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20080306000690 CA Practitioner - Diagnostic Radiology 5092709881 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Yale University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

1425 S Main St
Walnut Creek, CA 94596-5318
Phone (925) 295-4000

4501 Sand Creek Rd
Antioch, CA 94531-8687
Phone (925) 813-6500

901 Nevin Ave
Richmond, CA 94801-3143
Phone (510) 307-1500

975 Sereno Dr
Vallejo, CA 94589-2441
Phone (707) 651-1000

Hospital & facility affiliations

  • Kaiser Foundation Hospital - Antioch Hospital, Antioch, CA, CCN 050760
  • Kaiser Foundation Hospital - Walnut Creek Hospital, Walnut Creek, CA, CCN 050072

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55851CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group, Inc CurrentSince Apr 29, 2013 Accepting new patients
Permanente Medical Group Inc Diagnostic Radiology Current Accepting new patients
Permanente Medical Group Inc Diagnostic Radiology CurrentSince Apr 29, 2013 Accepting new patients
Pueblo Medical Imaging, LLC Diagnostic Radiology PastSince Dec 16, 1998 Accepting new patients
J Paul Wiesner & Associates Chartered Diagnostic Radiology PastSince Nov 3, 2019 Accepting new patients
John Muir Magnetic Imaging Center Diagnostic Radiology PastSince Mar 7, 1991 Accepting new patients
John Muir Health Past Accepting new patients
Bay Imaging Consultants Medical Group Inc Diagnostic Radiology Past Accepting new patients
John Muir Call Coverage Medical Group, Inc. Past Accepting new patients
John Muir Trauma Physicians Billing Service Diagnostic Radiology PastSince Jun 26, 2007 Accepting new patients

Locations

2070 Clinton Ave
Alameda, CA 94501
Phone (510) 522-3700

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

1425 S Main St
Walnut Creek, CA 94596
Phone (925) 295-4130

Organizations & group practices 10

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 2

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": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1285661090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 LENNON LN",
            "address_2": "SUITE 100",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945982485",
            "telephone_number": "925-296-1756",
            "fax_number": "925-296-7174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 YGNACIO VALLEY RD",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983122",
            "telephone_number": "925-296-7156",
            "fax_number": "925-296-7174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "MARSHA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A55851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1425 S Main St",
            "city": "Walnut Creek",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945965318",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

Verify at the official NPI Registry.