John Matthew Roberts Jr., D.O

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

3314 Issued in OK

Practice address

1717 S Utica Ave
Suite 103 the Eye Institute Inc
Tulsa, OK 74104-5317

Phone

(918) 743-2319

Fax

(918) 749-8870

NPI assigned

Sep 14, 2005

Last updated

Jul 17, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: j.roberts@direct.stjohnhealthsystem.com

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.

• The Eye Institute Inc

  • Ophthalmology Physician
  • Tulsa, OK
  • NPI 1982638516
  Medicare reassignment NPD
• Marc a Goldberg MD PC

  dba Marc A Goldberg MD Optical

  • Eyewear Supplier
  • Tulsa, OK
  • NPI 1174836241
  NPD (past)

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216252800000",
    "number": "1730174954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 S UTICA AVE",
            "address_2": "SUITE 103 THE EYE INSTITUTE INC",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045317",
            "telephone_number": "918-743-2319",
            "fax_number": "918-749-8870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 S UTICA AVE",
            "address_2": "SUITE 103 THE EYE INSTITUTE INC",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045317",
            "telephone_number": "918-743-2319",
            "fax_number": "918-749-8870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "JOHN",
        "middle_name": "MATTHEW",
        "name_suffix": "Jr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-14",
        "last_updated": "2008-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OK",
            "license": "3314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100150630A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Russell Roberts
• Jarrod Roberts
• Jennifer Roberts, PHARMD
• Jillian Becca Roberts, AU.D.
• John Glen Roberts Jr., PTA
• Juan A Roberts
• Kalynn Roberts
• Katelyn Roberts
• Kevin Glenn Roberts
• Kimberly Roberts, SLP

• Ophthalmology Physician in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Ophthalmology Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.