Gavin Roberts, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

01043662A Issued in IN

Practice address

702 Barnhill Dr
Indianapolis, IN 46202-5128

Phone

(317) 274-8103

Fax

(317) 274-1111

NPI assigned

Aug 12, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: groberts10552@direct.franciscanalliance.org
• Direct secure messaging: groberts35056@direct.eskenazihealth.edu
• Direct secure messaging: groberts@direct.iuhealth.org

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.

• Gavin J. Roberts, MD

  • Ophthalmology Physician
  • Indianapolis, IN
  • NPI 1447369665
  NPD (past) Authorized official
• University Family Physicians, Inc.

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1043275787
  NPD
• University Family Physicians, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Indianapolis, IN
  • NPI 1669828042
  NPD
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692

  Ophthalmology

  NPD (past)

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210032000000",
    "number": "1477555035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 UNIVERSITY BLVD",
            "address_2": "SUITE 3080",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025149",
            "telephone_number": "317-274-1034",
            "fax_number": "317-274-3265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 BARNHILL DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025128",
            "telephone_number": "317-274-8103",
            "fax_number": "317-274-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "GAVIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2008-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IN",
            "license": "01043662A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200112290",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dustin Michael Roberts, PHARMD
• Elizabeth Roberts
• Elizabeth Loveland Roberts, NP
• Ellen Brattain Roberts, CPNP
• Emily Claire Roberts, LMHC
• Gregory John Roberts, M.D.
• Isaac Joseph Roberts
• Jacob Odell Roberts, D.C.
• Jacqueline Kelly Roberts, MD
• Jada Marie Roberts

• Ophthalmology Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Ophthalmology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2008; 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.