Lee Michael Robak, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

95 86 Issued in NM

Practice address

1316 Jackie Rd SE Ste 900
Rio Rancho, NM 87124-6612

Phone

(505) 892-7518

Fax

(505) 892-9092

NPI assigned

Nov 21, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NM

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Westside Family Medicine

  • Family Medicine Physician
  • Rio Rancho, NM
  • NPI 1023146354
  NPD (past) Authorized official
• Trauma Treatment Center LLC

  • Community/Behavioral Health Agency
  • Rio Rancho, NM
  • NPI 1427567486
  NPD (past)

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417022740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1316 JACKIE RD SE STE 900",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871246612",
            "telephone_number": "505-892-7518",
            "fax_number": "505-892-9092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1316 JACKIE RD SE STE 900",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871246612",
            "telephone_number": "505-892-7518",
            "fax_number": "505-892-9092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBAK",
        "first_name": "LEE",
        "middle_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "95 86",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "R5756",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Riverside Center for Family and Cosmetic Dentitry (Riverside Dental and Beauty Spa)
• Riverview Quilt LLC (Riverview Assisted Living)
• Anne Marie Riviere
• Amanda Leigh Roark, MSW, LCSW
• Josephine M Roback, PAC
• Robben R. Gingery, MD
• Robben R. Gingery, MD, LLC
• Robert C Kerschen, DMD
• Caroline Roberts
• Elizabeth Roberts

• Family Medicine Physician in Rio Rancho, NM
• Providers in Rio Rancho, NM by specialty
• Family Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.