Individual provider Active NPI

Marshall C Roberts, MD

  • Family Medicine Physician
  • San Diego, CA
National Provider Identifier
1750961843
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A189192 Issued in CA
Practice address
16899 W Bernardo Dr
San Diego, CA 92127-1603
Phone
(858) 499-2705
NPI assigned
Apr 12, 2021
Last updated
Jan 14, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A189192 CA Primary

Addresses

Primary practice location

16899 W Bernardo Dr
San Diego, CA 92127-1603

Mailing address

16899 W Bernardo Dr
San Diego, CA 92127-1603

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20240930004109 CA Practitioner - Family Practice 1759812860 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sharp Rees-Stealy Medical Group IncGroup PAC ID 8628972759, 872 clinicians

Practice addresses (Care Compare)

16899 W Bernardo Dr
San Diego, CA 92127-1603
Phone (858) 499-2600

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A189192CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sharp Rees-Stealy Medical Center Past Accepting new patients

Organizations & group practices 2

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1618185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1750961843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16899 W BERNARDO DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921271603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16899 W BERNARDO DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921271603",
            "telephone_number": "858-499-2705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "MARSHALL",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-12",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A189192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.