Charles A Roberts, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA1376 Issued in ME

Practice address

242 Brunswick St
Old Town, ME 04468-1613

Phone

(207) 827-6128

Fax

(207) 827-6605

NPI assigned

Jan 10, 2007

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 ME

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

Specialty

Physician Assistant

Education

University of Nebraska College of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Penobscot Community Health Center 135 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Penobscot Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Bangor, ME
  • NPI 1083259410
  Care Compare group NPD
• Penobscot Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Belfast, ME
  • NPI 1023458320
  Care Compare group
• Penobscot Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Winterport, ME
  • NPI 1093136871
  Care Compare group
• Penobscot Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Bangor, ME
  • NPI 1174845697
  Care Compare group
• Penobscot Community Health Center

  • Community/Retail Pharmacy
  • Brewer, ME
  • NPI 1336467695
  Care Compare group
• Penobscot Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Belfast, ME
  • NPI 1356683981
  Care Compare group
• Penobscot Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Bangor, ME
  • NPI 1427169010
  Care Compare group
• Penobscot Community Health Center

  • Specialist
  • Bangor, ME
  • NPI 1427338854
  Care Compare group
• Penobscot Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Bangor, ME
  • NPI 1568555498
  Care Compare group
• Penobscot Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Old Town, ME
  • NPI 1629161559
  Care Compare group
• Penobscot Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Jackman, ME
  • NPI 1669802849
  Care Compare group
• Penobscot Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Bangor, ME
  • NPI 1740373679
  Care Compare group

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1295884716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1599",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044021599",
            "telephone_number": "207-827-6128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 BRUNSWICK ST",
            "city": "OLD TOWN",
            "state": "ME",
            "postal_code": "044681613",
            "telephone_number": "207-827-6128",
            "fax_number": "207-827-6605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "CHARLES",
        "middle_name": "A",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA1376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Albert Ritter, MD
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• Chandra Mae Rogers
• Jonathan Roy
• Shyla L Russell, PA-C
• Saco Bay Orthopaedic and Sports Physical Therapy, Inc.
• Lorraine Sarullo, DC

• All providers in Old Town, ME
• Physician Assistant in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2021; 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.