Individual provider Active NPI

Michael J Robertson, MD

  • Family Medicine Physician
  • Franklin, OH
National Provider Identifier
1417301664
Registry record updated Oct 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35.136095 Issued in OH
Practice address
5275 State Route 122 Ste 100
Franklin, OH 45005-9617
Phone
(513) 424-7291
Fax
(513) 424-2289
NPI assigned
Apr 14, 2016
Last updated
Oct 4, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X 35.136095 OH Primary

Addresses

Primary practice location

5275 State Route 122 Ste 100
Franklin, OH 45005-9617

Mailing address

5275 State Route 122 Ste 100
Franklin, OH 45005-9617
Phone (513) 424-7291

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20190906002737 OH Practitioner - Family Practice 0547552309 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wright State University Boonshoft School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mvhe IncGroup PAC ID 9537066584, 399 clinicians
Oxford Physical Therapy and RehabilitationGroup PAC ID 0244232874, 432 clinicians

Practice addresses (Care Compare)

2451 Wayne Ave
Dayton, OH 45420-1893
Phone (937) 252-1831

5275 State Route 122
Suite 100
Franklin, OH 45005-9617
Phone (513) 424-7291

7567 Central Parke Blvd
A
Mason, OH 45040-6852

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.136095OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mvhe Inc CurrentSince Sep 16, 2019 Accepting new patients
Mvhe Inc Single Specialty CurrentSince Sep 16, 2019 Accepting new patients
Mvhe Inc Past Accepting new patients

Locations

722 N Fairfield Rd
Beavercreek, OH 45434
Phone (937) 208-7000

2451 Wayne Ave
Dayton, OH 45420
Phone (937) 252-1831

5275 State Route 122
Ste 100
Franklin, OH 45005
Phone (513) 424-7291

3170 Kettering Blvd
Bldg B
Moraine, OH 45439
Phone (937) 991-3187

Organizations & group practices 4

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 3

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

NPI Registry JSON

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

{
    "created_epoch": "1460592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570147200000",
    "number": "1417301664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5275 STATE ROUTE 122 STE 100",
            "city": "FRANKLIN",
            "state": "OH",
            "postal_code": "450059617",
            "telephone_number": "513-424-7291",
            "fax_number": "513-424-2289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5275 STATE ROUTE 122 STE 100",
            "city": "FRANKLIN",
            "state": "OH",
            "postal_code": "450059617",
            "telephone_number": "513-424-7291",
            "fax_number": "513-424-2289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-14",
        "last_updated": "2019-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.136095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Franklin, OH

Sources for this page

Verify at the official NPI Registry.