Individual provider Active NPI

Wilmer Burton Roberts, MD, PH.D.

  • Urology Physician
  • Lake Jackson, TX
National Provider Identifier
1346391653
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
S7326 Issued in TX
Practice address
210 Lake Rd Ste 200
Lake Jackson, TX 77566-4982
Phone
(979) 299-0011
NPI assigned
Jan 15, 2007
Last updated
Aug 6, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X AJ4147357 MD
Urology Physician 208800000X 245650 MA
Urology Physician 208800000X S7326 TX Primary

Addresses

Primary practice location

210 Lake Rd Ste 200
Lake Jackson, TX 77566-4982

Mailing address

210 Lake Rd Ste 200
Lake Jackson, TX 77566-4982
Phone (979) 299-0011

Other practice location 1

133 Brookline Ave
Boston, MA 02215-3904
Phone (617) 421-8749

Other identifiers 1

IdentifierTypeStateIssuer
110086918AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20200820003575 TX Practitioner - Urology 6507051182 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baylor St. Luke's Medical GroupGroup PAC ID 9133213192, 172 clinicians

Practice addresses (Care Compare)

208 Oak Dr S
Suite 200
Lake Jackson, TX 77566-5640
Phone (979) 285-3633

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AJ4147357MDMDOrthopaedic Surgery Physician
245650MAMDUrology Physician
S7326TXMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor College of Medicine CurrentSince Jan 30, 2021 Accepting new patients
Baylor St. Luke's Medical Group CurrentSince Jul 21, 2020 Accepting new patients
Baylor College of Medicine Urology CurrentSince Jan 30, 2021 Accepting new patients

Locations

2 Greenway Plz
Ste 900
Houston, TX 77046
Phone (713) 798-1835

6624 Fannin St
Ste 1240
Houston, TX 77030
Phone (832) 355-5575

7200 Cambridge St
Fl 1
Houston, TX 77030
Phone (713) 798-3924

7200 Cambridge St
Fl 10
Houston, TX 77030
Phone 7137981750 ext. 2

7200 Cambridge St
Fl 9
Houston, TX 77030
Phone (713) 798-2273

120 Flag Lake Dr
Ste 1
Lake Jackson, TX 77566
Phone (979) 299-6900

208 Oak Dr S
Ste 200
Lake Jackson, TX 77566
Phone (979) 285-1802

210 Lake Rd
Ste 200
Lake Jackson, TX 77566
Phone (979) 299-0011

1201 W Frank Ave
Lufkin, TX 75904
Phone (936) 634-8111

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JIHBCA
  • Direct secure messaging: wilmer.roberts@memc.eclinicaldirectplus.com
  • Direct secure messaging: wroberts234790@direct.stlukeshealth.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1346391653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 LAKE RD STE 200",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775664982",
            "telephone_number": "979-299-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 LAKE RD STE 200",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775664982",
            "telephone_number": "979-299-0011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "133 Brookline Ave",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "022153904",
            "country_code": "US",
            "telephone_number": "617-421-8749",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "WILMER",
        "middle_name": "BURTON",
        "name_prefix": "Dr.",
        "credential": "MD, PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-15",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MD",
            "license": "AJ4147357",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MA",
            "license": "245650",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "TX",
            "license": "S7326",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110086918A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Jackson, TX

Sources for this page

Verify at the official NPI Registry.