Individual provider Active NPI

R Michael Roberts, MD

  • Rheumatology Physician
  • Princeton, NJ
National Provider Identifier
1396735429
Registry record updated Sep 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
25MA02945000 Issued in NJ
Practice address
601 Ewing St
A-8
Princeton, NJ 08540-2757
Phone
(609) 921-6555
Fax
(609) 924-5911
NPI assigned
Oct 28, 2005
Last updated
Sep 16, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 25MA02945000 NJ Primary

Addresses

Primary practice location

601 Ewing St
A-8
Princeton, NJ 08540-2757

Mailing address

601 Ewing St
A-8
Princeton, NJ 08540-2757
Phone (609) 921-6555

Other identifiers 1

IdentifierTypeStateIssuer
3035000MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20050816000624 NJ Practitioner - RheumatologyPractitioner - Internal Medicine 5193755528 Practice locations: Princeton, NJ

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA02945000NJMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Jersey Arthritis and Osteoporosis, LLC PastSince Jan 1, 2011 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.

NPI Registry JSON

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

{
    "created_epoch": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284595200000",
    "number": "1396735429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 EWING ST",
            "address_2": "A-8",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085402757",
            "telephone_number": "609-921-6555",
            "fax_number": "609-924-5911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 EWING ST",
            "address_2": "A-8",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085402757",
            "telephone_number": "609-921-6555",
            "fax_number": "609-924-5911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "R",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-28",
        "last_updated": "2010-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NJ",
            "license": "25MA02945000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3035000",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, NJ

Sources for this page

Verify at the official NPI Registry.