Individual provider Active NPI

Karen L Roberts, DO

  • Neuromusculoskeletal Medicine & OMM Physician
  • Portland, ME
National Provider Identifier
1366467508
Registry record updated Jul 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X
License
1838 Issued in ME
Practice address
535 Ocean Ave
Portland, ME 04103-4973
Phone
(207) 541-9285
Fax
(207) 773-7340
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 1838 ME
Neuromusculoskeletal Medicine & OMM Physician 204D00000X 1838 ME Primary

Addresses

Primary practice location

535 Ocean Ave
Portland, ME 04103-4973

Mailing address

535 Ocean Ave
Portland, ME 04103-4973
Phone (207) 541-9285

Other identifiers 1

IdentifierTypeStateIssuer
413520099MedicaidME

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040923000306 ME Practitioner - Osteopathic Manipulative MedicinePractitioner - Family Practice 4183692585 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Osteopathic Manipulative MedicineAlso: Family Practice
Education
University of New England, College of Osteo Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

66 Leighton Rd
Suite 1
Falmouth, ME 04105-2225
Phone (207) 541-9285

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1838MEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth Current Accepting new patients
Hospital Osteopathic Manipulative Medicine PC Neuromusculoskeletal Medicine & Omm Past Accepting new patients

Locations

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

Organizations & group practices 4

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343001600000",
    "number": "1366467508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 OCEAN AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041034973",
            "telephone_number": "207-541-9285",
            "fax_number": "207-773-7340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 OCEAN AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041034973",
            "telephone_number": "207-541-9285",
            "fax_number": "207-773-7340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "KAREN",
        "middle_name": "L",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2012-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "1838",
            "primary": false
        },
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "ME",
            "license": "1838",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "413520099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.