Individual provider Active NPI

Robert L Humble, MD

  • Urology Physician
  • Monroe, LA
National Provider Identifier
1285665554
Registry record updated Jun 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
016842 Issued in LA
Practice address
2516 Broadmoor Blvd
Monroe, LA 71201-2987
Phone
(318) 807-1390
Fax
(318) 807-1394
NPI assigned
Jul 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 016842 LA Primary

Addresses

Primary practice location

2516 Broadmoor Blvd
Monroe, LA 71201-2987

Mailing address

130 Desiard St
Suite 355
Monroe, LA 71201-7319
Phone (318) 807-7875

Other identifiers 1

IdentifierTypeStateIssuer
1348414MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20131007000401 LA Practitioner - Urology 5991838740 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.51 of 100Reported as apm
Quality
60.04
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
016842LAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Health Group, LLC CurrentSince Sep 9, 2013 Accepting new patients
Affinity Health Group, LLC Urology Current Accepting new patients
Baton Rouge Clinic, a Medical Corporation Urology CurrentSince Oct 1, 2024 Accepting new patients
Baton Rouge Clinic, a Medical Corporation CurrentSince Oct 1, 2024 Accepting new patients
Affinity Health Group, LLC CurrentSince Sep 9, 2013 Accepting new patients
Vicksburg Clinic LLC Urology Past Accepting new patients
Vicksburg Clinic LLC Past Accepting new patients
Vicksburg Clinic LLC Urology Past Accepting new patients

Locations

7373 Perkins Rd
Baton Rouge, LA 70808
Phone (225) 246-9790

2516 Broadmoor Blvd
Monroe, LA 71201
Phone (318) 322-1161

2408 Broadmoor Blvd
Ste 2
Monroe, LA 71201
Phone (318) 807-0525

130 Desiard St
Ste 355
Monroe, LA 71201
Phone (318) 807-7875

130 Desiard St
Ste A
Monroe, LA 71201

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1285665554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 DESIARD ST",
            "address_2": "SUITE 355",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712017319",
            "telephone_number": "318-807-7875",
            "fax_number": "318-812-6603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2516 BROADMOOR BLVD",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712012987",
            "telephone_number": "318-807-1390",
            "fax_number": "318-807-1394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMBLE",
        "first_name": "ROBERT",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "LA",
            "license": "016842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1348414",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

Verify at the official NPI Registry.