Individual provider Active NPI

Tania R Robertson, MD

  • Internal Medicine Physician
  • Belcourt, ND
National Provider Identifier
1699938738
Registry record updated Mar 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D72751 Issued in MD
Practice address
#1 Hospital Road
Belcourt, ND 58316-0160
Phone
(701) 477-6111
Fax
(701) 477-2507
NPI assigned
Jul 9, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D72751 MD Primary

Addresses

Primary practice location

#1 Hospital Road
Belcourt, ND 58316-0160

Mailing address

#1 Hospital Road
Belcourt, ND 58316-0160
Phone (701) 477-6111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20150327002194 TX Practitioner - Internal Medicine 4880864594 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D72751MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Quentin N Burdick Comprehensive Health Care Facility CurrentSince Feb 22, 2015 Accepting new patients
Quentin N Burdick Comprehensive Health Care Facility Past Accepting new patients
Medstar Good Samaritan Physicians LLC Past Accepting new patients
The Good Samaritan Hospital of Maryland, Inc. Past Accepting new patients

Locations

1300 Hospital Loop
Belcourt, ND 58316

4100 W 150th St
#3
Cleveland, OH 44135

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1215561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426464000000",
    "number": "1699938738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "#1 HOSPITAL ROAD",
            "city": "BELCOURT",
            "state": "ND",
            "postal_code": "583160160",
            "telephone_number": "701-477-6111",
            "fax_number": "701-477-2507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "#1 HOSPITAL ROAD",
            "city": "BELCOURT",
            "state": "ND",
            "postal_code": "583160160",
            "telephone_number": "701-477-6111",
            "fax_number": "701-477-2507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "TANIA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-09",
        "last_updated": "2015-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D72751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belcourt, ND

Sources for this page

Verify at the official NPI Registry.