Individual provider Active NPI

Clive E Roberson, MD

  • Allergy & Immunology Physician
  • West Palm Beach, FL
National Provider Identifier
1497748123
Registry record updated Sep 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
ME9904 Issued in FL
Practice address
1411 N Flagler Dr
Suite #6100
West Palm Beach, FL 33401-3404
Phone
(561) 655-4450
Fax
(561) 655-4469
NPI assigned
Aug 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X ME9904 FL Primary

Addresses

Primary practice location

1411 N Flagler Dr
Suite #6100
West Palm Beach, FL 33401-3404

Mailing address

1411 N Flagler Dr Ste 3000
West Palm Beach, FL 33401-3425
Phone (561) 655-4450

Other identifiers 1

IdentifierTypeStateIssuer
044509600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20110103000228 FL Practitioner - Allergy/Immunology 4284616871 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Duke University School of Medicine, 1960
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10115 W Frest Hill Blvd
Suite 403
Wellington, FL 33414-3103
Phone (561) 792-5436

1411 N Flager Dr
Suite 3000
West Palm Beach, FL 33401-3425
Phone (561) 655-4450

210 Jupiter Lakes Blvd
Suite 5203
Jupiter, FL 33458-7192
Phone (561) 747-5057

900 E Ocean Blvd
Suite D334
Stuart, FL 34994-2471
Phone (772) 220-8884

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: croberson20694@jupitermedicalcenter.direct-ci.com

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1125273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601251200000",
    "number": "1497748123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 N FLAGLER DR STE 3000",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334013425",
            "telephone_number": "561-655-4450",
            "fax_number": "561-655-4469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 N FLAGLER DR",
            "address_2": "SUITE #6100",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334013404",
            "telephone_number": "561-655-4450",
            "fax_number": "561-655-4469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERSON",
        "first_name": "CLIVE",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-29",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "FL",
            "license": "ME9904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "044509600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.