Individual provider Active NPI

David W Roberson, MD

  • Otolaryngology Physician
  • Milford, DE
National Provider Identifier
1447221015
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
C1-0013142 Issued in DE
Practice address
101 Wellness Way Ste 300
Milford, DE 19963-4366
Phone
(302) 393-5009
Fax
(302) 424-9211
NPI assigned
Jan 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X C1-0013142 DE Primary

Addresses

Primary practice location

101 Wellness Way Ste 300
Milford, DE 19963-4366

Mailing address

640 S. State Street
Mail Code 3055
Dover, DE 19901-3530
Phone (302) 393-5009

Other practice location 1

826 S Governors Ave
Dover, DE 19904-4107
Phone (302) 674-3752

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20190719000797 DE Practitioner - Otolaryngology 8729023486 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of North Carolina at Chapel Hill School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bayhealth Medical Center, IncGroup PAC ID 1658364740, 399 clinicians

Practice addresses (Care Compare)

826 S Governors Ave
Bayhealth Ear Nose Throat
Dover, DE 19904-4107
Phone (302) 674-3752

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C1-0013142DEMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bayhealth Medical Center, Inc CurrentSince Jun 17, 2019 Accepting new patients
Bayhealth Medical Center, Inc Otolaryngology CurrentSince Jun 17, 2019 Accepting new patients

Locations

640 S State St
#3055
Dover, DE 19901
Phone (302) 480-1688

826 S Governors Ave
Dover, DE 19904
Phone (302) 674-3752

640 S State St
Dover, DE 19901
Phone (302) 744-4700

806 Seabury Ave
Milford, DE 19963
Phone (301) 424-7522

101 Wellness Way
Ste 300
Milford, DE 19963
Phone (302) 393-5009

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1447221015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 S. STATE STREET",
            "address_2": "MAIL CODE 3055",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199013530",
            "telephone_number": "302-393-5009",
            "fax_number": "302-424-9211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 WELLNESS WAY STE 300",
            "city": "MILFORD",
            "state": "DE",
            "postal_code": "199634366",
            "telephone_number": "302-393-5009",
            "fax_number": "302-424-9211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "826 S Governors Ave",
            "address_purpose": "LOCATION",
            "city": "Dover",
            "state": "DE",
            "postal_code": "199044107",
            "country_code": "US",
            "telephone_number": "302-674-3752",
            "fax_number": "302-674-8521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERSON",
        "first_name": "DAVID",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-31",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "DE",
            "license": "C1-0013142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, DE

Sources for this page

Verify at the official NPI Registry.