Cullen Fullerton Roberts, MD

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

License

353094 Issued in LA

Practice address

1514 Jefferson Hwy
Jefferson, LA 70121-2451

Phone

(504) 842-3000

NPI assigned

Mar 25, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1553472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783209600000",
    "number": "1447710488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 JEFFERSON HWY",
            "city": "JEFFERSON",
            "state": "LA",
            "postal_code": "701212451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1514 JEFFERSON HWY",
            "city": "JEFFERSON",
            "state": "LA",
            "postal_code": "701212451",
            "telephone_number": "504-842-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "CULLEN",
        "middle_name": "FULLERTON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-25",
        "last_updated": "2026-07-05",
        "certification_date": "2026-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "LA",
            "license": "353094",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "280551",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Riverdale SBHC
• Gabrielle Rivers
• Alexander Antoine Rizk, MD
• Frank Rizzuto
• Olivia Roberie, AGACNP-BC
• Rustin Lance Roberts, M.D.
• Asha Robinson-Parks, MD
• Sean Robinson, MD
• Dominic Robles
• Raenell Roche

• Colon & Rectal Surgery Physician in Jefferson, LA
• Providers in Jefferson, LA by specialty
• Colon & Rectal Surgery Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2026; 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.