Bradley Robertson, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

H7648 Issued in TX

Practice address

1809 Capital Dr
Tyler, TX 75701-8438

Phone

(903) 509-4499

Fax

(903) 509-4490

NPI assigned

Jun 13, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

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 Medicine

Practice roles

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.

• Complete Emergency Care Tyler LLC

  • Emergency Care Clinic/Center
  • Tyler, TX
  • NPI 1124486857
  NPD (past)
• Hood Emergency Medicine Associates PA

  • Emergency Medicine Physician
  • Granbury, TX
  • NPI 1457495608
  NPD (past)
• Mother Frances Hospital

  • Certified Registered Nurse Anesthetist
  • Tyler, TX
  • NPI 1629185210
  NPD (past)

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207008000000",
    "number": "1760425326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1809 CAPITAL DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757018438",
            "telephone_number": "903-509-4499",
            "fax_number": "903-509-4490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 CAPITAL DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757018438",
            "telephone_number": "903-509-4499",
            "fax_number": "903-509-4490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "BRADLEY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2008-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "H7648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0080EJ",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139171613",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paul B Roberts, MD
• Robyn Liane Roberts, MD
• Ron L Roberts, MS
• Steven Bruce Roberts, MD
• Timothy Duane Roberts, LICENSED PROFESSIONA
• Colvin Earl Robertson Jr., PHARM.D.
• Edwin D Robertson, PHD
• Dolar Robinett, COTA
• Judith M Robinett, L.P.C.
• Charles Edward Robinson Jr., DDS

• Emergency Medicine Physician in Tyler, TX
• Providers in Tyler, TX by specialty
• Emergency Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.