Individual provider Active NPI

Justine Marie Roberts, PA-C

  • Physician Assistant
  • Murrysville, PA
National Provider Identifier
1609002880
Registry record updated Jul 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA053847 Issued in PA
Practice address
4057 Old William Penn Hwy
Murrysville, PA 15668-1846
Phone
(724) 216-3353
NPI assigned
Jun 2, 2009
Last updated
Jul 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA053847 PA Primary

Addresses

Primary practice location

4057 Old William Penn Hwy
Murrysville, PA 15668-1846

Mailing address

251 Terrace Dr
Lilly, PA 15938-5819
Phone (814) 934-3126

Other practice location 1

723 Broad St
Duncansville, PA 16635-9450
Phone (814) 515-9919

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA053847PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Windber Hospital, Inc. Past Accepting new patients
Plastic Surgical Associates of Johnstown Inc Past Accepting new patients
Avlc Altoona, LLC Past Accepting new patients
Plastic Surgical Associates of Johnstown Inc Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1243900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690329600000",
    "number": "1609002880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 TERRACE DR",
            "city": "LILLY",
            "state": "PA",
            "postal_code": "159385819",
            "telephone_number": "814-934-3126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4057 OLD WILLIAM PENN HWY",
            "city": "MURRYSVILLE",
            "state": "PA",
            "postal_code": "156681846",
            "telephone_number": "724-216-3353"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "723 Broad St",
            "address_purpose": "LOCATION",
            "city": "Duncansville",
            "state": "PA",
            "postal_code": "166359450",
            "country_code": "US",
            "telephone_number": "814-515-9919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "JUSTINE",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-02",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA053847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murrysville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.