Individual provider Active NPI

Brian K Roberts, PA-C

  • Surgical Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1508956202
Registry record updated Apr 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
25MP00065900 Issued in NJ
Practice address
3400 Spruce Street
4 Silverstein
Philadelphia, PA 19104-4206
Phone
(215) 615-4949
NPI assigned
Oct 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA051149 PA
Surgical Physician Assistant 363AS0400X 25MP00065900 NJ Primary

Addresses

Primary practice location

3400 Spruce Street
4 Silverstein
Philadelphia, PA 19104-4206

Mailing address

3400 Spruce Street
4 Silverstein
Philadelphia, PA 19104-4206
Phone (215) 615-4949

Other practice location 1

1 Brace Rd Ste H
Cherry Hill, NJ 08034-2600
Phone (856) 547-0389

Other practice location 2

141 Route 70 E Ste B
Marlton, NJ 08053-1855
Phone (856) 596-9057

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address broberts101217@directvirtua.org
Direct Messaging Address broberts101217@directvirtua.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050203000236 NJ Practitioner - Physician Assistant 3678524030 Reassigns benefits to 4 organizations
I20110517000352 PA Practitioner - Physician Assistant 3678524030 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians
University of Penn-Medical GroupGroup PAC ID 6204730955, shared by 15 NPIs, 3,433 clinicians

Practice addresses (Care Compare)

1600 Haddon Ave
Camden, NJ 08103-3101

175 Madison Ave
Mount Holly, NJ 08060-2038

3242 Route 206
Bordentown, NJ 08505-4517

3400 Spruce St
Philadelphia, PA 19104-4206

3400 Spruce Street 5 White BLDG
Oral and Maxillofacial Surgery Hup
Philadelphia, PA 19104-4206
Phone (215) 829-6079

Hospital & facility affiliations

  • Virtua Our Lady of Lourdes Hospital Hospital, Camden, NJ, CCN 310029
  • West Jersey Hospital Hospital, Voorhees, NJ, CCN 310022

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA051149PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group CurrentSince May 25, 2015 Accepting new patients
Atlanticare Physician Group, PA CurrentSince Jan 6, 2020 Accepting new patients
CMC Department of Medicine Group PA CurrentSince Aug 31, 2010 Accepting new patients
Virtua Medical Group, PA CurrentSince Aug 1, 2020 Accepting new patients
Virtua Medical Group, PA CurrentSince Aug 1, 2020 Accepting new patients
Cooper Surgical Associates, PA CurrentSince Dec 3, 2010 Accepting new patients
CMC Department of Medicine Group PA CurrentSince Aug 31, 2010 Accepting new patients
University of Penn-Medical Group CurrentSince May 25, 2015 Accepting new patients
Trustees of the University of Pennsylvania Past Accepting new patients
Virtua Medical Group, PA Past Accepting new patients

Locations

3242 Route 206
Ste 2
Bordentown, NJ 08505
Phone (609) 298-4340

333 Irving Ave
Bridgeton, NJ 08302
Phone (856) 575-4500

1 Cooper Plz
Camden, NJ 08103
Phone (856) 342-2425

3 Cooper Plz
Rm 215
Camden, NJ 08103
Phone (856) 342-2439

3 Cooper Plz
Rm 411
Camden, NJ 08103
Phone (856) 342-2270

1600 Haddon Ave
Camden, NJ 08103
Phone (609) 757-3500

1 Brace Rd
Ste H
Cherry Hill, NJ 08034
Phone (856) 547-0389

1935 Route 70 E
Cherry Hill, NJ 08003
Phone (856) 246-3920

459 Route 9 S
Little Egg Harbor Twp, NJ 08087
Phone (609) 340-7815

141 Route 70 E
Ste B
Marlton, NJ 08053
Phone (856) 596-9057

301 Lippincott Dr
Ste 120
Marlton, NJ 08053
Phone (856) 355-0333

1505 W Sherman Ave
Vineland, NJ 08360
Phone (856) 451-6600

509 N Broad St
Woodbury, NJ 08096
Phone (856) 686-5396

3400 Spruce St
Fl 6
Philadelphia, PA 19104
Phone (215) 615-0800

3400 Spruce St
Fl 4
Philadelphia, PA 19104
Phone (215) 662-2050

51 N 39th St
Fl 2
Philadelphia, PA 19104
Phone (215) 662-9010

800 Walnut St
Fl 20
William Penn Annex West, PA 19107
Phone (215) 829-2092

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 2

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775606400000",
    "number": "1508956202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE STREET",
            "address_2": "4 SILVERSTEIN",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044206",
            "telephone_number": "215-615-4949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE STREET",
            "address_2": "4 SILVERSTEIN",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044206",
            "telephone_number": "215-615-4949"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Brace Rd Ste H",
            "address_purpose": "LOCATION",
            "city": "Cherry Hill",
            "state": "NJ",
            "postal_code": "080342600",
            "country_code": "US",
            "telephone_number": "856-547-0389",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "141 Route 70 E Ste B",
            "address_purpose": "LOCATION",
            "city": "Marlton",
            "state": "NJ",
            "postal_code": "080531855",
            "country_code": "US",
            "telephone_number": "856-596-9057",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "BRIAN",
        "middle_name": "K",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA051149",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00065900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "broberts101217@directvirtua.org",
            "affiliation": "N",
            "address_1": "141 Route 70 E Ste B",
            "city": "Marlton",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080531855",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "broberts101217@directvirtua.org",
            "affiliation": "N",
            "address_1": "1 Brace Rd Ste H",
            "city": "Cherry Hill",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080342600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.