NPIMap

Individual provider Active NPI

Alisa Roberts, DO

  • Emergency Medicine Physician
  • Van Wert, OH
National Provider Identifier
1639153224
Registry record updated Oct 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
34008346 Issued in OH
Practice address
1250 S Washington St
Phoenix Emergency Physicians of the Midwest
Van Wert, OH 45891-2551
Phone
(419) 238-8611
NPI assigned
Dec 6, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 34008346 OH Primary

Addresses

Primary practice location

1250 S Washington St
Phoenix Emergency Physicians of the Midwest
Van Wert, OH 45891-2551

Mailing address

4425 Smith Stewart Rd
Vienna, OH 44473-9619

Other identifiers 3

IdentifierTypeStateIssuer
2621265MedicaidOH
000000522415OtherOHANTHEM
000000537055OtherOHANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, MI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20051206000630 OH Practitioner - Emergency Medicine 3577583475 Reassigns benefits to 7 organizations
I20190906000179 MI Practitioner - Emergency Medicine 3577583475 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Toledo HospitalGroup PAC ID 2961309638, 118 clinicians
Emergency Physicians of Northwest Ohio, Inc.Group PAC ID 3375456478, 102 clinicians

Practice addresses (Care Compare)

1075 Medical Ctr Pkwy
Maumee, OH 43537
Phone (567) 585-0800

718 N Macomb St
Monroe, MI 48162-7815
Phone (734) 240-8400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.25 of 100Reported as group
Quality
96.55
Improvement activities
40
Cost
89.76

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34008346OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Haematology-Oncology Associates of Ohio and Michigan PC Current Accepting new patients
The Toledo Hospital CurrentSince Jul 13, 2022 Accepting new patients
The Toledo Hospital Current Accepting new patients
The Toledo Hospital CurrentSince Jul 13, 2022 Accepting new patients
Observation Physicians of Northwest Ohio LLC Emergency Medicine CurrentSince Apr 1, 2021 Accepting new patients
Emergency Physicians of Northwest Ohio Inc. Emergency Medicine CurrentSince Aug 1, 2006 Accepting new patients
Consultants in Laboratory Medicine of Greater Toledo Current Accepting new patients
Joint Township District Memorial Hospital CurrentSince Feb 3, 2018 Accepting new patients
Mves Austintown LLC Emergency Medicine CurrentSince Mar 1, 2010 Accepting new patients
Mahoning Valley Emergency Specialists LLC Emergency Medicine CurrentSince Jul 1, 2006 Accepting new patients
Emergency Physicians of Northwest Ohio, LLC Emergency Medicine Past Accepting new patients
JTDM Family Practice LLC Family Medicine Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Ohio Em-I Medical Services, Professional Association Past Accepting new patients

Locations

718 N Macomb St
Monroe, MI 48162
Phone (734) 212-3097

501 Van Buren St
Fostoria, OH 44830
Phone (419) 435-7734

1001 Bellefontaine Ave
Lima, OH 45804
Phone (419) 228-3335

1075 Medical Center Pkwy
Maumee, OH 43537
Phone (567) 585-0800

200 Saint Clair Ave
Saint Marys, OH 45885
Phone (419) 394-3387

2142 N Cove Blvd
Toledo, OH 43606
Phone (419) 291-1111

1044 Belmont Ave
Youngstown, OH 44504
Phone (330) 480-2182

6252 Mahoning Ave
Youngstown, OH 44515
Phone (330) 792-7418

8401 Market St
Youngstown, OH 44512
Phone (330) 729-2929

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 7

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": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288224000000",
    "number": "1639153224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4425 SMITH STEWART RD",
            "city": "VIENNA",
            "state": "OH",
            "postal_code": "444739619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 S WASHINGTON ST",
            "address_2": "PHOENIX EMERGENCY PHYSICIANS OF THE MIDWEST",
            "city": "VAN WERT",
            "state": "OH",
            "postal_code": "458912551",
            "telephone_number": "419-238-8611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "ALISA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-06",
        "last_updated": "2010-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "34008346",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2621265",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000522415",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000537055",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Wert, OH

Sources for this page

Verify at the official NPI Registry.