Individual provider Active NPI

Mont R Roberts, DO

  • Emergency Medicine Physician
  • Fort Wayne, IN
National Provider Identifier
1497248355
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
5101024009 Issued in MI
Practice address
7950 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone
(260) 435-7001
NPI assigned
Jun 14, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 5101024009 MI Primary
Emergency Medicine Physician 207P00000X 02006341A IN

Addresses

Primary practice location

7950 W Jefferson Blvd
Fort Wayne, IN 46804-4140

Mailing address

124 W Superior St Unit 622
Fort Wayne, IN 46802-1258
Phone (517) 881-1245

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20210419001614 IN Practitioner - Emergency Medicine 9931517646 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
02006341AINMDEmergency Medicine Physician
5101024009MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Professionals of Indiana, P.C. Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients

Locations

303 S Main St
Bluffton, IN 46714
Phone (260) 824-0800

3700 Washington Ave
Evansville, IN 47714
Phone (812) 232-0021

2520 E DuPont Rd
Fort Wayne, IN 46825
Phone (219) 407-8000

702 Van Buren St
Fort Wayne, IN 46802
Phone (260) 425-3000

7950 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 434-7088

275 W 12th St
Peru, IN 46970
Phone (317) 472-8022

85 E US Highway 6
Valparaiso, IN 46383
Phone (219) 983-5743

2101 Dubois Dr
Warsaw, IN 46580
Phone (219) 267-3200

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1528934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1497248355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 W SUPERIOR ST UNIT 622",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468021258",
            "telephone_number": "517-881-1245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7950 W JEFFERSON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044140",
            "telephone_number": "260-435-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "MONT",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-14",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101024009",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "02006341A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.