Michael Warren Roberts, DO

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

OS21386 Issued in FL

Practice address

209 Palermo PL Unit C
Venice, FL 34285-2821

Phone

(941) 488-5300

Fax

(941) 412-1003

NPI assigned

Aug 27, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA, FL, SC3 enrollments

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 3

Specialty

DermatologyAlso: Micrographic Dermatologic Surgery (MDS)

Education

Lake Erie College of Osteopathic Medicine, Erie, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Leavitt Medical Associates of Florida IncGroup PAC ID 4688579311, 199 clinicians

Advanced Dermatology of SC PCGroup PAC ID 4284864372, 32 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

83.67 of 100Reported as group

Quality

80.78

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Leavitt Medical Associates of Florida Inc

  dba Advanced Dermatology and Cosmetic Surq

  • Dermatology Physician
  • Sebastian, FL
  • NPI 1083872535
  Medicare reassignment Care Compare group NPD
• Advanced Dermatology of SC PC

  • Dermatology Physician
  • Spartanburg, SC
  • NPI 1255754008
  Medicare reassignment Care Compare group NPD
• Aqua Dermatology of Georgia PC

  dba Goodman Dermatology, Skin Cancer Specialists PC & Aesthetics Center

  • Dermatology Physician
  • Marietta, GA
  • NPI 1114022167
  Medicare reassignment NPD
• Goodman Dermatology, PC

  • Dermatology Physician
  • Roswell, GA
  • NPI 1770801144
  Medicare reassignment NPD
• Leavitt Medical Associates of Florida Inc

  dba Advanced Dermatolgy and Cosmetic Surgery

  • Dermatology Physician
  • Debary, FL
  • NPI 1942468434
  NPD
• Dermatopathology Lab of Skin Cancer Specialists, P.C.

  • Clinical Medical Laboratory
  • Marietta, GA
  • NPI 1083044465
  NPD
• Leavitt Medical Associates of Florida Inc

  dba Advanced Dermatology And Cosmetic Surgery

  • Dermatology Physician
  • Heathrow, FL
  • NPI 1528097284
  NPD (past)

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

{
    "created_epoch": "1503792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1710404082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 PALERMO PL UNIT C",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342852821",
            "telephone_number": "941-488-5300",
            "fax_number": "941-412-1003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 PALERMO PL UNIT C",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342852821",
            "telephone_number": "941-488-5300",
            "fax_number": "941-412-1003"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 Hospital Blvd Ste 280",
            "address_purpose": "LOCATION",
            "city": "Roswell",
            "state": "GA",
            "postal_code": "300764918",
            "country_code": "US",
            "telephone_number": "770-754-0787",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "MICHAEL",
        "middle_name": "WARREN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-27",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "86263",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "OS21386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert L Dubin MD PA
• Christopher Allen Roberts, MD
• Elysa Roberts, PHD, OTRL
• Jennifer L Roberts, PA-C
• Michael Don Roberts, M.D.
• Eileen Robertson, REGISTERED CLINICAL
• Robin Mathews, LMFT, Individual and Marriage Therapist, Inc.
• Boyd Allan Robinson, DPM
• Terri Robinson
• Rocky Mountain Holdings, LLC (Bayflite)

• Dermatology Physician in Venice, FL
• Providers in Venice, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.