Roberto M. Icarro, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

051049 Issued in GA

Practice address

1743 Watson Blvd
Suite B
Warner Robins, GA 31093-3633

Phone

(478) 328-2122

Fax

(478) 929-2242

NPI assigned

May 4, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Primary Healthcare Center, P.C.

  • Physician Assistant
  • Warner Robins, GA
  • NPI 1477666782
  NPD (past)

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256860800000",
    "number": "1497703193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1743 WATSON BLVD",
            "address_2": "SUITE B",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310933633",
            "telephone_number": "478-328-2122",
            "fax_number": "478-929-2242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1743 WATSON BLVD",
            "address_2": "SUITE B",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310933633",
            "telephone_number": "478-328-2122",
            "fax_number": "478-929-2242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ICARRO",
        "first_name": "ROBERTO",
        "middle_name": "M.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2009-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "051049",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "GA",
            "license": "051049",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000944633C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janika Huston
• Nanette Hutson
• William Alexander Hvizdzak, PT, DPT
• Martha Christine Hyde
• Hypertension and Kidney Associates of Middle Georgia, LLC
• Omorogiuwa O Iguobadia, MD
• Imaging Centers of Georgia, Inc.
• Impact Therapy of Georgia (Impact Therapy)
• Infection Specialists of Middle Georgia, LLC
• Infectious Disease Clinic LLC

• Internal Medicine Physician in Warner Robins, GA
• Providers in Warner Robins, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2009; 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.