NPIMap

Individual provider Active NPI

Mark T Roberts, M.D.

  • Neurology Physician
  • Miami, FL
National Provider Identifier
1699338640
Registry record updated Aug 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
ME171744 Issued in FL
Practice address
1611 NW 12TH Ave
Miami, FL 33136-1005
Phone
(305) 243-7520
NPI assigned
Apr 16, 2019
Reactivated
Apr 3, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X ME171744 FL Primary

Addresses

Primary practice location

1611 NW 12TH Ave
Miami, FL 33136-1005

Mailing address

1611 NW 12TH Ave
Miami, FL 33136-1005
Phone (305) 585-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, FL2 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
I20230814001416 MI Practitioner - Neurology 8224364278 Reassigns benefits to 1 organization
I20250627000093 FL Practitioner - Neuropsychiatry 8224364278 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neuropsychiatry
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of MiamiGroup PAC ID 3274795109, 2,346 clinicians

Practice addresses (Care Compare)

1150 NW 14TH St
Professional Arts Building
Miami, FL 33136-2137
Phone (305) 585-5215

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME171744FLMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan CurrentSince Jun 30, 2023 Accepting new patients
Regents of the University of Michigan Neurology CurrentSince Jun 30, 2023 Accepting new patients
University of Miami Neurology CurrentSince Jun 1, 2025 Accepting new patients
Regents of the University of Michigan Current Accepting new patients
University of Miami CurrentSince Jun 1, 2025 Accepting new patients
University of Miami Current Accepting new patients

Locations

4800 NE 20th Ter
Ste 201
Ft Lauderdale, FL 33308
Phone (305) 892-4000

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

1150 NW 14th St
Miami, FL 33136
Phone (305) 243-6165

1801 NW 9th Ave
Fl 6
Miami, FL 33136
Phone (305) 355-5006

3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

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 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1555372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755043200000",
    "number": "1699338640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 NW 12TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361005",
            "telephone_number": "305-585-6000",
            "fax_number": "305-243-6858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 NW 12TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361005",
            "telephone_number": "305-243-7520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "MARK",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-16",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "deactivation_date": "2019-12-04",
        "reactivation_date": "2020-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME171744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.