Susan Roberts, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A-1723-13 Issued in NM

Practice address

2050A 2ND St SE
Kirtland Afb, NM 87117-5522

Phone

(505) 846-3200

NPI assigned

Jul 19, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Texan Urgent Care PLLC

  • Emergency Medicine Physician
  • Scottsdale, AZ
  • NPI 1346545209
  NPD
• American Current Care, P.a.

  • Health Service Clinic/Center
  • Addison, TX
  • NPI 1730360124
  NPD (past)
• Big Bend Medical Group

  • Surgery Physician
  • Big Spring, TX
  • NPI 1811973282

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617753600000",
    "number": "1437158896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26028",
            "address_2": "CLINICIAN SERVICES",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871256028",
            "telephone_number": "505-237-8700",
            "fax_number": "505-237-8703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050A 2ND ST SE",
            "city": "KIRTLAND AFB",
            "state": "NM",
            "postal_code": "871175522",
            "telephone_number": "505-846-3200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12405 Himalayan Way NE",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "87111",
            "country_code": "US",
            "telephone_number": "505-999-0121",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12405 Himalayan Way NE",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "87111",
            "country_code": "US",
            "telephone_number": "505-999-0121",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12405 Himalayan Way NE",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "87111",
            "country_code": "US",
            "telephone_number": "505-999-0121",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12405 Himalayan Way NE",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "87111",
            "country_code": "US",
            "telephone_number": "505-999-0121",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2301 S Gregg St",
            "address_purpose": "LOCATION",
            "city": "Big Spring",
            "state": "TX",
            "postal_code": "797205531",
            "country_code": "US",
            "telephone_number": "432-267-5531",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "SUSAN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-19",
        "last_updated": "2021-04-07",
        "certification_date": "2021-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K2574",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "A-1723-13",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "153862101",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00002166",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bryan Presler, PSYD
• David Allan Quackenbush, DO
• Martha Vanessa Ragsdale, LCSW
• Winfield Scott Revels, PT
• Adamaris Rivera Santiago, PHARMD
• Michael Anthony Robinson, MD
• Rafael Antonio Rojo
• Kim M Romero, LISW
• Ellen Roska, PHARM. D.
• Morgan L Saucedo, MS, RD/LD

• Family Medicine Physician in Kirtland Afb, NM
• Providers in Kirtland Afb, 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 Apr 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.