Active NPI
Brooke Marie Roebuck, MD
- Pediatrics Physician
- Newport, RI
National Provider Identifier
1386905073
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD16497
- Practice address
- 164 Broadway
Newport, RI 02840-2747 - Phone
- (401) 267-9928
- Fax
- (401) 753-7519
- NPI assigned
- May 30, 2012
- Last updated
- Oct 2, 2026
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 29288 | OK | |
| Pediatrics Physician | 208000000X | MD16497 | RI | Primary |
Addresses
Primary practice location
164 Broadway
Newport, RI 02840-2747
Mailing address
164 Broadway
Newport, RI 02840-2747
Phone (401) 267-9928
Other practice location 1
1272 W Main Rd
Middletown, RI 02842
Phone (401) 847-2290
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29288 | OK | MD | Pediatrics Physician |
| MD16497 | RI | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aquidneck Pediatrics LLC | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pediatrics Physician
- Middletown, RI
- NPI 1245681626
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1338336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1790899200000",
"number": "1386905073",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "164 BROADWAY",
"city": "NEWPORT",
"state": "RI",
"postal_code": "028402747",
"telephone_number": "401-267-9928",
"fax_number": "401-753-7519"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "164 BROADWAY",
"city": "NEWPORT",
"state": "RI",
"postal_code": "028402747",
"telephone_number": "401-267-9928",
"fax_number": "401-753-7519"
}
],
"practiceLocations": [
{
"address_1": "1272 W Main Rd",
"address_purpose": "LOCATION",
"city": "Middletown",
"state": "RI",
"postal_code": "02842",
"country_code": "US",
"telephone_number": "401-847-2290",
"fax_number": "401-849-8446",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROEBUCK",
"first_name": "BROOKE",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-05-30",
"last_updated": "2026-10-02",
"certification_date": "2026-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "OK",
"license": "29288",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "RI",
"license": "MD16497",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newport, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.