Active NPI
Joan Therese Roberts, M.D.
- Ophthalmology Physician
- Durham, NC
National Provider Identifier
1376521831
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 9401000
- Practice address
- 4102 N Roxboro St
Durham, NC 27704-2122 - Phone
- (919) 595-2000
- Fax
- (919) 595-2190
- NPI assigned
- Jan 5, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 9401000 | NC | Primary |
Addresses
Primary practice location
4102 N Roxboro St
Durham, NC 27704-2122
Mailing address
4102 N Roxboro St
Durham, NC 27704-2122
Phone (919) 595-2000
Other identifiers 10
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 72175 | Other | NC | BCBSNC |
| 8972175 | Medicaid | NC | |
| 19535 | Other | NC | OPTICARE |
| 5612887674 | Other | NC | CIGNA |
| 0852210 | Other | NC | UNITED HEALTHCARE |
| 23492 | Other | NC | PARTNERS |
| 429966 | Other | NC | MAMSI |
| 52203 | Other | NC | MEDCOST |
| 4540511 | Other | NC | AETNA PPO |
| 2442919 | Other | NC | AETNA HMO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9401000 | NC | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Duke Health Integrated Practice, Inc. | Past | Accepting new patients | |
| North Carolina Eye Ear Nose & Throat PA | Ophthalmology | Past | Accepting new patients |
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.
-
- General Practice Physician
- Durham, NC
- NPI 1205553369
-
- Ophthalmology Physician
- Durham, NC
- NPI 1972504926
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136419200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192060800000",
"number": "1376521831",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4102 N ROXBORO ST",
"city": "DURHAM",
"state": "NC",
"postal_code": "277042122",
"telephone_number": "919-595-2000",
"fax_number": "919-595-2190"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4102 N ROXBORO ST",
"city": "DURHAM",
"state": "NC",
"postal_code": "277042122",
"telephone_number": "919-595-2000",
"fax_number": "919-595-2190"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "JOAN",
"middle_name": "THERESE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-05",
"last_updated": "2007-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "NC",
"license": "9401000",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSNC",
"identifier": "72175",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8972175",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OPTICARE",
"identifier": "19535",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "5612887674",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "0852210",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PARTNERS",
"identifier": "23492",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI",
"identifier": "429966",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST",
"identifier": "52203",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PPO",
"identifier": "4540511",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO",
"identifier": "2442919",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2007; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.