Suzanne G Roberts, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD15516 Issued in ME

Practice address

1 Granny Smith Court
Old Orchard Beach, ME 04064

Phone

(207) 934-7276

Fax

(207) 934-0465

NPI assigned

Mar 31, 2011

Last updated

Sep 4, 2014By 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

Other names 1

• Suzanne Grondin Roberts Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1301529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409788800000",
    "number": "1316236300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "BIDDEFORD",
            "state": "ME",
            "postal_code": "040059422",
            "telephone_number": "207-282-9080",
            "fax_number": "207-934-0465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GRANNY SMITH COURT",
            "city": "OLD ORCHARD BEACH",
            "state": "ME",
            "postal_code": "04064",
            "telephone_number": "207-934-7276",
            "fax_number": "207-934-0465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "SUZANNE",
        "middle_name": "G",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-31",
        "last_updated": "2014-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ME",
            "license": "MD15516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316236300",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUZANNE",
            "last_name": "GRONDIN ROBERTS",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Internal Medicine Physician in Old Orchard Beach, ME
• Providers in Old Orchard Beach, ME by specialty
• Internal Medicine Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.