Active NPI
Ted Robertson II, M.D.
- Obstetrics & Gynecology Physician
- Daytona Beach, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- ME104386
- Practice address
- 500 Health Blvd
Daytona Beach, FL 32114-1492 - Phone
- (386) 252-5858
- Fax
- (386) 252-4477
- NPI assigned
- Feb 10, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | ME104386 | FL | Primary |
| Obstetrics & Gynecology Physician | 207V00000X | 35.071420 | OH |
Addresses
Primary practice location
500 Health Blvd
Daytona Beach, FL 32114-1492
Mailing address
500 Health Blvd
Daytona Beach, FL 32114-1492
Phone (386) 252-5858
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 002343800 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Obstetrics/Gynecology
- Education
- Ohio State University College of Medicine, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3225 Aviation Ave
Suite 700
Miami, FL 33133-4741
Phone (305) 273-4641
500 Health Blvd
Daytona Beach, FL 32114-1492
Phone (386) 252-5858
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME104386 | FL | MD | Obstetrics & Gynecology Physician |
| 35.071420 | OH | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Hospital Healthcare Partners, Inc | Current | Accepting new patients | |
| Vitalmd Group Holding LLC | Obstetrics & Gynecology | Current | Accepting new patients |
| Volusia OB GYN | Obstetrics & Gynecology | Current | Accepting new patients |
Locations
305 Memorial Medical Pkwy
Ste 401
Daytona Beach, FL 32117
Phone (386) 231-3540
500 Health Blvd
Daytona Beach, FL 32114
Phone (386) 252-5858
301 Memorial Medical Pkwy
Holly Hill, FL 32117
Phone (386) 231-3906
3225 Aviation Ave
Ste 700
Miami, FL 33133
Phone (305) 273-4641
1055 Saxon Blvd
Orange City, FL 32763
Phone (386) 917-5000
61 Memorial Medical Pkwy
Ste 1-800A
Palm Coast, FL 32164
Phone (386) 586-1810
60 Memorial Medical Pkwy
Palm Coast, FL 32164
Phone (385) 586-2000
3641 Clyde Morris Blvd
Ste 100
Port Orange, FL 32129
Phone (305) 500-2114
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/BBHJCA
Organizations & group practices 3
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.
-
- Obstetrics & Gynecology Physician
- Miami, FL
- NPI 1871572032
-
- Internal Medicine Physician
- Daytona Beach, FL
- NPI 1780100529
-
- Obstetrics & Gynecology Physician
- Daytona Beach, FL
- NPI 1720037211
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba AdventHealth Daytona Beach
- General Acute Care Hospital
- Daytona Beach, FL
- NPI 1063426823
-
dba AdventHealth Daytona Beach
- Clinical Medical Laboratory
- Daytona Beach, FL
- NPI 1104696178
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139529600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643068800000",
"number": "1609849496",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 HEALTH BLVD",
"city": "DAYTONA BEACH",
"state": "FL",
"postal_code": "321141492",
"telephone_number": "386-252-5858",
"fax_number": "386-252-4477"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 HEALTH BLVD",
"city": "DAYTONA BEACH",
"state": "FL",
"postal_code": "321141492",
"telephone_number": "386-252-5858",
"fax_number": "386-252-4477"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTSON",
"first_name": "TED",
"name_prefix": "Dr.",
"name_suffix": "II",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-10",
"last_updated": "2022-01-25",
"certification_date": "2022-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "FL",
"license": "ME104386",
"primary": true
},
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "OH",
"license": "35.071420",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "002343800",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Daytona Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.