Individual provider Active NPI

Pamela Roberts, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Fort Pierce, FL
National Provider Identifier
1700893310
Registry record updated Jan 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
ME63493 Issued in FL
Practice address
2100 Nebraska Ave
Suite 202
Fort Pierce, FL 34950-4704
Phone
(772) 465-8100
Fax
(772) 465-8689
NPI assigned
Aug 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X ME63493 FL Primary

Addresses

Primary practice location

2100 Nebraska Ave
Suite 202
Fort Pierce, FL 34950-4704

Mailing address

2100 Nebraska Ave
Suite 202
Fort Pierce, FL 34950-4704
Phone (772) 465-8100

Other identifiers 1

IdentifierTypeStateIssuer
49718OtherFLBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Vain Clinic LLC Past Accepting new patients
Thoracic & Cardiovascular Surgeons LLC Thoracic Surgery (Cardiothoracic Vascular Surgery) Past Accepting new patients
Lawnwood Cardiovascular Surgery LLC Thoracic Surgery (Cardiothoracic Vascular Surgery) Past Accepting new patients

Organizations & group practices 3

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": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201046400000",
    "number": "1700893310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 NEBRASKA AVE",
            "address_2": "SUITE 202",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349504704",
            "telephone_number": "772-465-8100",
            "fax_number": "772-465-8689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 NEBRASKA AVE",
            "address_2": "SUITE 202",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349504704",
            "telephone_number": "772-465-8100",
            "fax_number": "772-465-8689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "PAMELA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2008-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "FL",
            "license": "ME63493",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "49718",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.