John Warren Robertson III, MD

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

MD044947E Issued in PA

Practice address

501 Gopher Dr
Tomah, WI 54660-4513

Phone

(608) 372-2181

NPI assigned

Jun 29, 2006

Last updated

Jan 4, 2021By 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

General Surgery

Education

Howard University College of Medicine, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tomah Memorial Hospital IncGroup PAC ID 6901897016, shared by 4 NPIs, 54 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tomah Memorial Hospital Hospital, Tomah, WI, CCN 521320

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jrobertsoniii625533@direct.emplifyhealth.org

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Tomah Memorial Hospital Inc

  dba Tomah Health

  • Critical Access Hospital
  • Tomah, WI
  • NPI 1184765240

  Corporate Director

  CMS ownership
• Tomah Memorial Hospital Inc

  dba Hospice Touch

  • Community Based Hospice Care Agency
  • Tomah, WI
  • NPI 1588706329

  Corporate Director

  CMS ownership

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.

• Tomah Memorial Hospital Inc

  dba Tomah Health

  • Critical Access Hospital
  • Tomah, WI
  • NPI 1184765240
  Medicare reassignment NPD
• Tomah Memorial Hospital Inc

  dba Tomah Health

  • Critical Access Hospital
  • Tomah, WI
  • NPI 1992970453
  Medicare reassignment NPD
• Tomah Memorial Hospital Inc

  dba Tomah Memorial Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Tomah, WI
  • NPI 1205978046
  NPD
• Sandra Vause, M.D., P.C.

  • Dermatology Physician
  • Logan Township, NJ
  • NPI 1467524355
  NPD (past)
• The Behavioral Wellness Center at Girard

  • Methadone Clinic
  • Philadelphia, PA
  • NPI 1598798928
  NPD (past)

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

• Tomah Memorial Hospital Inc

  dba Tomah Health

  • Critical Access Hospital
  • Tomah, WI
  • NPI 1184765240
  Care Compare affiliation

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609718400000",
    "number": "1770511578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 GOPHER DR",
            "city": "TOMAH",
            "state": "WI",
            "postal_code": "546604513",
            "telephone_number": "608-372-2181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 GOPHER DR",
            "city": "TOMAH",
            "state": "WI",
            "postal_code": "546604513",
            "telephone_number": "608-372-2181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1940 E Walnut Lane",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "19138",
            "country_code": "US",
            "telephone_number": "215-424-7099",
            "fax_number": "215-424-0706",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "JOHN",
        "middle_name": "WARREN",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "PA",
            "license": "MD044947E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001304593007",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jrobertson10785@direct.monroeclinic.org",
            "affiliation": "Y",
            "affiliationName": "Tomah Memorial Hospital Inc",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "jrobertson10785@direct.monroeclinic.org",
            "address_1": "501 Gopher Dr",
            "city": "Tomah",
            "state": "WI",
            "country_code": "US",
            "postal_code": "546604513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amanda Roberge, MSW, LCSW
• Cathryn Irene Roberts, MD
• Haili Roberts
• Lori Roberts, RN
• Lori Ann Roberts, MSW
• Courtney Nichole Robinson, RN
• Susan Robinson, RD
• Emily Ann Rodriguez, CNM
• Vanessa Rose Rogich, DNP, APNP, FNP-C
• Kayde Rohn

• Vascular Surgery Physician in Tomah, WI
• Providers in Tomah, WI by specialty
• Vascular Surgery Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.