NPIMap

Individual provider Active NPI

Mark R Roberts, DO

  • Internal Medicine Physician
  • Stillwater, MN
National Provider Identifier
1386740843
Registry record updated Nov 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
57061 Issued in MN
Practice address
1500 Curve Crest Blvd W
Stillwater, MN 55082-6040
Phone
(651) 439-1234
NPI assigned
Sep 15, 2006
Last updated
Nov 25, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 43835 WI
Internal Medicine Physician 207R00000X 57061 MN Primary

Addresses

Primary practice location

1500 Curve Crest Blvd W
Stillwater, MN 55082-6040

Mailing address

8170 33Rd Ave S # Ms 21110Q
Minneapolis, MN 55425-4516

Other identifiers 1

IdentifierTypeStateIssuer
43495500MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040503000894 WI Practitioner - Internal Medicine 3678561305 Reassigns benefits to 3 organizations
I20131218001613 MN Practitioner - Internal Medicine 3678561305 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians
Westfields Hospital IncGroup PAC ID 2264490960, 108 clinicians

Practice addresses (Care Compare)

1500 Curve Crest W Blvd
Stillwater, MN 55082-6040
Phone (651) 439-1234

535 Hospital Rd
New Richmond, WI 54017-1449
Phone (715) 243-2600

700 Rivard St
Somerset, WI 54025-7382
Phone (715) 247-2060

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57061MNMDInternal Medicine Physician
43835WIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Westfields Hospital, Inc. CurrentSince Feb 15, 2015 Accepting new patients
Group Health, Inc. CurrentSince Jan 1, 2016 Accepting new patients
Westfields Hospital, Inc CurrentSince Feb 15, 2015 Accepting new patients
Group Health, Inc. CurrentSince Jan 1, 2016 Accepting new patients
Westfields Hospital, Inc. CurrentSince Dec 30, 2025 Accepting new patients
Group Health, Inc. CurrentSince Jan 1, 2016 Accepting new patients
Marshfield Clinic Inc Current Accepting new patients

Locations

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

8170 33rd Ave S
Minneapolis, MN 55425
Phone (952) 883-5463

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

1500 Curve Crest Blvd W
Stillwater, MN 55082

921 Greeley St S
Stillwater, MN 55082

1000 Starr Ave
Eau Claire, WI 54703
Phone (715) 858-4850

906 College Ave W
Ladysmith, WI 54848
Phone (715) 532-2300

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

535 Hospital Rd
New Richmond, WI 54017
Phone (651) 292-2013

1020 Lakeshore Dr
Rice Lake, WI 54868
Phone (715) 236-8100

700 Rivard St
Somerset, WI 54025
Phone (715) 247-2060

744 E Louisiana St
St Croix Fls, WI 54024
Phone (651) 772-6251

Interoperability endpoints

  • Direct secure messaging: mroberts112262@direct.healthpartners.com

Organizations & group practices 7

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 20

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574640000000",
    "number": "1386740843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S # MS 21110Q",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 CURVE CREST BLVD W",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550826040",
            "telephone_number": "651-439-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "MARK",
        "middle_name": "R",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2019-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "43835",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "57061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43495500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stillwater, MN

Sources for this page

Verify at the official NPI Registry.