Mary Roberts, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

105 N Keene St Ste 201
Columbia, MO 65201-8131

Phone

(573) 499-4990

Fax

(573) 442-2120

NPI assigned

Nov 15, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Missouri Cancer Associates LLCGroup PAC ID 8729975305, 22 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Boone Hospital Center Hospital, Columbia, MO, CCN 260068
• Pershing Memorial Hospital Hospital, Brookfield, MO, CCN 261307
• University of Missouri Health Care Hospital, Columbia, MO, CCN 260141
• Northeast Regional Medical Center Hospital, Kirksville, MO, CCN 260022

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mary.roberts@mca.ikm.direct-ci.com

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.

• Missouri Cancer Associates LLC

  • Oncology Clinic/Center
  • Columbia, MO
  • NPI 1215947338
  Medicare reassignment Care Compare group NPD

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

• CH Allied Services, Inc

  • Cardiac Rehabilitation Clinic/Center
  • Columbia, MO
  • NPI 1548734734

  Hospital

  Care Compare affiliation
• CH Allied Services, Inc.

  • General Acute Care Hospital
  • Columbia, MO
  • NPI 1902817844
  Care Compare affiliation
• Curators of the University of Missouri

  • General Acute Care Hospital
  • Jefferson City, MO
  • NPI 1174597892
  Care Compare affiliation
• Curators of the University of Missouri

  • General Acute Care Hospital
  • Columbia, MO
  • NPI 1699769901
  Care Compare affiliation
• General John J Pershing Memorial Hospital Association

  • Critical Access Hospital
  • Brookfield, MO
  • NPI 1417991159
  Care Compare affiliation
• Kirksville Missouri Hospital Company, LLC

  • General Acute Care Hospital
  • Kirksville, MO
  • NPI 1104899442
  Care Compare affiliation

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

{
    "created_epoch": "1668470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1447969787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 N KEENE ST STE 201",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652018131",
            "telephone_number": "573-499-4990",
            "fax_number": "573-442-2120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 N KEENE ST STE 201",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652018131",
            "telephone_number": "573-499-4990",
            "fax_number": "573-442-2120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5104 Sockeye Ct",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MO",
            "postal_code": "652036489",
            "country_code": "US",
            "telephone_number": "573-999-1692",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "MARY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-15",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Mary.Roberts@mca.ikm.direct-ci.com",
            "affiliation": "N",
            "address_1": "105 N Keene St",
            "city": "Columbia",
            "state": "MO",
            "country_code": "US",
            "postal_code": "652018377",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ashley Roberts
• Cody James Roberts, DO
• Jeffrey A Roberts, LCSW
• Jon D Roberts, MD
• Marjorie Lynne Roberts, LPC
• Nicholas Roberts
• Bailey Marie Robertson, RN
• Deborah H. Robertson, APRN, BC, FNP
• Michael Wesley Robertson, MD
• Quayd Robertson, D.O

• Physician Assistant in Columbia, MO
• Providers in Columbia, MO by specialty
• Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.