Keith A Robertson, M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

A07336 Issued in CA

Practice address

696 Hampshire Rd
Ste 200
Westlake Village, CA 91361-2699

Phone

(805) 497-0817

Fax

(805) 497-8933

NPI assigned

Dec 29, 2006

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

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Orthopedic Surgery

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Body Dynamix Integrated Sports Medicine IncGroup PAC ID 4688003221, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Body Dynamix Integrated Sports Medicine, Inc

  • Physical Medicine & Rehabilitation Physician
  • Tarzana, CA
  • NPI 1912386376
  Medicare reassignment Care Compare group NPD
• Body Dynamix Chiropractic and Performance

  • Chiropractor
  • Encino, CA
  • NPI 1619145331
  NPD (past)
• Harbor Family and Pediatric Medical

  dba Channel Islands Medical Group

  • Specialist
  • Ventura, CA
  • NPI 1679759286
  NPD (past)
• Los Robles Regional Medical Center

  dba Los Robles Hospital & Medical Center

  • General Acute Care Hospital
  • Thousand Oaks, CA
  • NPI 1033163019
  NPD (past)

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290729600000",
    "number": "1619033925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "696 HAMPSHIRE RD",
            "address_2": "STE 200",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913612699",
            "telephone_number": "805-497-0817",
            "fax_number": "805-497-8933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "696 HAMPSHIRE RD",
            "address_2": "STE 200",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913612699",
            "telephone_number": "805-497-0817",
            "fax_number": "805-497-8933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "KEITH",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-29",
        "last_updated": "2010-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "A07336",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A703360",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Briana Roberts, SLP-CCC M.A.
• Elizabeth A Roberts
• Jennifer Roberts, BA
• Rena Ganine Roberts, MFT
• Jennifer Robertson, LPCC
• Coby Robinson
• Jill Helene Rodewald, LCSW
• Amber Marie Rodriguez
• Archibald Edmundo Rodriguez, D.C.
• Veronica Lara Rodriguez, M.A., B.C.B.A.

• Orthopaedic Surgery Physician in Westlake Village, CA
• Providers in Westlake Village, CA by specialty
• Orthopaedic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2010; 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.

Verify at the official NPI Registry.