Sean M. Roberts

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

000671 Issued in NY

Practice address

1300 Elmwood Ave # 108
Buffalo, NY 14222-1004

Phone

(716) 878-5328

Fax

(716) 878-3536

NPI assigned

Sep 10, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1568073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1558910752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 BIGELOW RD",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142251507",
            "telephone_number": "716-989-8119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 ELMWOOD AVE # 108",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142221004",
            "telephone_number": "716-878-5328",
            "fax_number": "716-878-3536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "SEAN",
        "middle_name": "M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-10",
        "last_updated": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": "000671",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVERS LICENSE",
            "identifier": "734698967",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Buffalo",
            "affiliation": "Y",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1300 Elmwood Ave # 108",
            "city": "Buffalo",
            "state": "NY",
            "country_code": "US",
            "postal_code": "142221004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jianna Roberts, M.A.
• Jillian Roberts, L.M.T.
• Jodie Roberts
• Karen Roberts
• Kiara Roberts
• Susan Ann Terranova Roberts, AUD
• Donique Brent Robertsn, LPN
• Robertson Holdings LLC
• Bernice Robertson
• Julie Robertson

• Athletic Trainer in Buffalo, NY
• Providers in Buffalo, NY by specialty
• Athletic Trainer in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.