Active NPI
David Hillel Roberts, MD
- Pulmonary Disease Physician
- Boston, MA
National Provider Identifier
1558350660
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- 152595
- Practice address
- 330 Brookline Ave
Ksb23, Bidmc Pulmonary
Boston, MA 02215-5400 - Phone
- (617) 667-5864
- Fax
- (617) 667-4849
- NPI assigned
- Oct 20, 2005
- Last updated
- Feb 14, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 152595 | MA | |
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | 152595 | MA | |
| Pulmonary Disease Physician | 207RP1001X | 152595 | MA | Primary |
Addresses
Primary practice location
330 Brookline Ave
Ksb23, Bidmc Pulmonary
Boston, MA 02215-5400
Mailing address
330 Brookline Ave
Ksb23, Bidmc Pulmonary
Boston, MA 02215-5400
Phone (617) 667-5864
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0137910 | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 152595 | MA | MD | Critical Care Medicine (Internal Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
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- Dermatology Physician
- Boston, MA
- NPI 1043250616
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129766400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1297641600000",
"number": "1558350660",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "330 BROOKLINE AVE",
"address_2": "KSB23, BIDMC PULMONARY",
"city": "BOSTON",
"state": "MA",
"postal_code": "022155400",
"telephone_number": "617-667-5864",
"fax_number": "617-667-4849"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 BROOKLINE AVE",
"address_2": "KSB23, BIDMC PULMONARY",
"city": "BOSTON",
"state": "MA",
"postal_code": "022155400",
"telephone_number": "617-667-5864",
"fax_number": "617-667-4849"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "DAVID",
"middle_name": "HILLEL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-20",
"last_updated": "2011-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MA",
"license": "152595",
"primary": false
},
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "MA",
"license": "152595",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "MA",
"license": "152595",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0137910",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.