NPIMap

Individual provider Active NPI

Douglas E. Roberts Jr., M.D.

  • Internal Medicine Physician
  • Ridgecrest, CA
National Provider Identifier
1508869926
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G35606 Issued in CA
Practice address
900 N Heritage Dr
BLDG E
Ridgecrest, CA 93555-5536
Phone
(760) 446-4571
Fax
(760) 446-0970
NPI assigned
May 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G35606 CA Primary

Addresses

Primary practice location

900 N Heritage Dr
BLDG E
Ridgecrest, CA 93555-5536

Mailing address

900 N Heritage Dr
BLDG E
Ridgecrest, CA 93555-5536
Phone (760) 446-4571

Other identifiers 8

IdentifierTypeStateIssuer
00G356060OtherBLUE SHIELD
CA0103OtherJOHN DEERE
00G356060MedicaidCA
00G356060OtherCOMMERCIAL INS.
0616650001OtherDME
93555B036OtherWPS TRICARE
00G356060OtherBLUE CROSS
110039741OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080711000385 CA Practitioner - Internal Medicine 9537231261 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Perelman School of Med at the University of Pennsylvania, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Douglas E Roberts Jr MD a Professional CorporationGroup PAC ID 8921154592, 3 clinicians

Practice addresses (Care Compare)

900 N Heritage Dr
Suite E
Ridgecrest, CA 93555-5537
Phone (760) 446-4571

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
56.8 of 100Reported as individual
Quality
0
Promoting interoperability
93
Improvement activities
40
Cost
61.85

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G35606CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Douglas E Roberts Jr MD a Professional Corporation Internal Medicine CurrentSince Jul 18, 2009 Accepting new patients
Ridgecrest Regional Hospital Past Accepting new patients
Quantum Healthcare Medical Associates Inc. Internal Medicine Past Accepting new patients

Locations

900 N Heritage Dr
Ste E
Ridgecrest, CA 93555
Phone (760) 446-4571

1111 N China Lake Blvd
Ridgecrest, CA 93555
Phone (760) 446-4571

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17265/brand/1/csg/1/fhir/r4

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1508869926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 N HERITAGE DR",
            "address_2": "BLDG E",
            "city": "RIDGECREST",
            "state": "CA",
            "postal_code": "935555536",
            "telephone_number": "760-446-4571",
            "fax_number": "760-446-0970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N HERITAGE DR",
            "address_2": "BLDG E",
            "city": "RIDGECREST",
            "state": "CA",
            "postal_code": "935555536",
            "telephone_number": "760-446-4571",
            "fax_number": "760-446-0970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "DOUGLAS",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G35606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00G356060",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "CA0103",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G356060",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL INS.",
            "identifier": "00G356060",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME",
            "identifier": "0616650001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WPS TRICARE",
            "identifier": "93555B036",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "00G356060",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110039741",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgecrest, CA

Sources for this page

Verify at the official NPI Registry.