Individual provider Active NPI

Anteneh Tesfaye Roba, MD

  • Emergency Medical Services (Emergency Medicine) Physician
  • Houston, TX
National Provider Identifier
1316974835
Registry record updated Oct 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
J3589 Issued in TX
Practice address
710 FM 1960 Rd W
Houston, TX 77090-3402
Phone
(281) 440-1000
NPI assigned
Jun 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X J3589 TX Primary
Emergency Medicine Physician 207P00000X J3589 TX

Addresses

Primary practice location

710 FM 1960 Rd W
Houston, TX 77090-3402

Mailing address

PO Box 5358
Norman, OK 73070-5358
Phone (866) 321-8433

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20151123002585 VA Practitioner - Emergency Medicine 4688604374 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
J3589TXMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
United Emergency Services, Inc. Emergency Medicine CurrentSince May 10, 2018 Accepting new patients
Southcrest Emergency Physicians PC Emergency Medical Services Past Accepting new patients

Locations

1535 Slate Creek Rd
Grundy, VA 24614
Phone (276) 935-1125

Organizations & group practices 2

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": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350432000000",
    "number": "1316974835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5358",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730705358",
            "telephone_number": "866-321-8433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 FM 1960 RD W",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770903402",
            "telephone_number": "281-440-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBA",
        "first_name": "ANTENEH",
        "middle_name": "TESFAYE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2012-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "TX",
            "license": "J3589",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "J3589",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.