Active NPI
Joel Fred Roberts, D.O.
- Family Medicine Physician
- Clearwater, FL
National Provider Identifier
1750344594
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- OS5636
- Practice address
- 2 N Belcher Rd
Clearwater, FL 33765-3201 - Phone
- (727) 446-4461
- Fax
- (727) 441-4107
- NPI assigned
- Apr 11, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | OS5636 | FL | Primary |
Addresses
Primary practice location
2 N Belcher Rd
Clearwater, FL 33765-3201
Mailing address
10225 Ulmerton Rd
Suite 1B
Largo, FL 33771-3538
Phone (727) 581-4849
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 044489800 | Medicaid | FL | |
| 80185 | Other | FL | BLUE CROSS BLUE SHIELD |
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)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 106412 | NY | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Our Family Doctors P L L C | Family Medicine | Past | Accepting new patients |
| Sun Coast Hospital Inc | Past | Accepting new patients | |
| Largo Physician Group, LLC | 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.
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-
- Family Medicine Physician
- Largo, FL
- NPI 1154417350
-
- General Acute Care Hospital
- Largo, FL
- NPI 1326058256
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314230400000",
"number": "1750344594",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10225 ULMERTON RD",
"address_2": "SUITE 1B",
"city": "LARGO",
"state": "FL",
"postal_code": "337713538",
"telephone_number": "727-581-4849",
"fax_number": "727-584-7429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 N BELCHER RD",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "337653201",
"telephone_number": "727-446-4461",
"fax_number": "727-441-4107"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "JOEL",
"middle_name": "FRED",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-11",
"last_updated": "2011-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "OS5636",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "044489800",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "80185",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clearwater, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.