Roberto Reble Bamba Jr., M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD2010-0169 Issued in NM

Practice address

407 S Schwartz Ave Ste 102
Farmington, NM 87401-5925

Phone

(505) 609-6700

Fax

(505) 609-6701

NPI assigned

Sep 6, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN, NM2 enrollments

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 2

Specialty

Pediatric Medicine

Education

Other, 1988

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Sanford Health of Northern Minnesota

  • Family Medicine Physician
  • Kelliher, MN
  • NPI 1770849697

  MN

  Medicare reassignment
• After Hours Pediatrics PC

  • Pediatrics Physician
  • Albuquerque, NM
  • NPI 1588730360

  Pediatrics

  NPD (past)
• San Juan Regional Medical Center Inc

  • Pediatrics Physician
  • Farmington, NM
  • NPI 1093800534

  Pediatrics

  NPD (past)
• San Juan Regional Medical Center Inc

  • Family Medicine Physician
  • Aztec, NM
  • NPI 1861467433
  NPD (past)
• San Juan Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Farmington, NM
  • NPI 1427058510
  NPD (past)
• Sanford Health of Northern Minnesota

  • Internal Medicine Physician
  • Bemidji, MN
  • NPI 1780628149
  NPD (past)

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

{
    "created_epoch": "1189036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785283200000",
    "number": "1497940175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 N SUNNY COVE PL",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857480038",
            "telephone_number": "505-486-0176",
            "fax_number": "520-523-6390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 S SCHWARTZ AVE STE 102",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874015925",
            "telephone_number": "505-609-6700",
            "fax_number": "505-609-6701"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7490 S Camino De Oeste",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857469308",
            "country_code": "US",
            "telephone_number": "520-670-3909",
            "fax_number": "529-309-2560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1300 Anne St NW",
            "address_purpose": "LOCATION",
            "city": "Bemidji",
            "state": "MN",
            "postal_code": "566015103",
            "country_code": "US",
            "telephone_number": "218-333-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5904 Holly Ave NE",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871132472",
            "country_code": "US",
            "telephone_number": "505-298-2505",
            "fax_number": "505-298-2985",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAMBA",
        "first_name": "ROBERTO",
        "middle_name": "REBLE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-06",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "81746",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "AZ",
            "license": "78630",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NM",
            "license": "MD2010-0169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "roberto.bamba@sjmedical.cernerdirect.com",
            "affiliation": "Y",
            "affiliationName": "SAN JUAN REGIONAL MEDICAL CENTER INC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "407 S Schwartz Ave",
            "address_2": "Suite 102",
            "city": "Farmington",
            "state": "NM",
            "country_code": "US",
            "postal_code": "874015925",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Pamela Bernice Balfour
• Jacqueline Ball
• Christopher Ballantine, ND
• Akshu Balwan, MBBS
• Joshua Allen Balzen, DDS
• Joshua Bancroft
• Yolanda Rae Barber, LMHC
• Barlow Therapy
• Taran Barney
• Eleanore A Barry-Prather, MD

• All providers in Farmington, NM
• Pediatrics Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2026; 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.