Individual provider Active NPI

Tadd Nicholas Roberts, M.D.

  • Emergency Medicine Physician
  • Louisville, KY
National Provider Identifier
1629240379
Registry record updated Mar 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
44330 Issued in KY
Practice address
4000 Kresge Way
Louisville, KY 40207-4605
Phone
(502) 897-8141
NPI assigned
Apr 1, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Basic Emergency Medical Technician 146N00000X 48445 KY
Emergency Medicine Physician 207P00000X 44330 KY Primary

Addresses

Primary practice location

4000 Kresge Way
Louisville, KY 40207-4605

Mailing address

PO Box 6749
Louisville, KY 40206-0749
Phone (502) 899-7716

Other identifiers 1

IdentifierTypeStateIssuer
7100137810MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20110207000298 KY Practitioner - Emergency Medicine 9638359706 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Louisville School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Louisville Observational Medicine Associates PSCGroup PAC ID 2860890704, 32 clinicians

Practice addresses (Care Compare)

4000 Kresge Way
Louisville, KY 40207-4605
Phone (502) 897-8100

Hospital & facility affiliations

  • Baptist Health Louisville Hospital, Louisville, KY, CCN 180130

Merit-based Incentive Payment System (MIPS)

Final score
88.66 of 100Reported as group
Quality
75.39
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
48445KYMDBasic Emergency Medical Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Louisville Observational Medicine Associates PSC Emergency Medicine CurrentSince Sep 7, 2021 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Oct 1, 2012 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Oct 1, 2012 Accepting new patients
Louisville Emergency Medicine Associates PSC Emergency Medicine CurrentSince Dec 1, 2020 Accepting new patients
University Medical Center, Inc Emergency Medicine Past Accepting new patients
University Emergency Medicine Associates P.S.C. Emergency Medicine Past Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

530 S Jackson St
Louisville, KY 40202
Phone (502) 562-3000

200 Abraham Flexner Way
Louisville, KY 40202
Phone (502) 569-7983

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

550 S Jackson St
Louisville, KY 40202
Phone (502) 561-8686

1903 W Hebron Ln
Shepherdsvlle, KY 40165
Phone (502) 587-4421

4000 Kresge Way
St Matthews, KY 40207
Phone (502) 459-7902

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1207008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648252800000",
    "number": "1629240379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6749",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402060749",
            "telephone_number": "502-899-7716",
            "fax_number": "502-899-7648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 KRESGE WAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074605",
            "telephone_number": "502-897-8141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "TADD",
        "middle_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-01",
        "last_updated": "2022-03-26",
        "certification_date": "2022-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "KY",
            "license": "48445",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "44330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100137810",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.