Michael Roberts, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

ME55375 Issued in FL

Practice address

3620 N 55TH Ave
Hollywood, FL 33021-2344

Phone

(954) 964-8480

Fax

(754) 400-8543

NPI assigned

May 23, 2005

Reactivated

Aug 3, 2016

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Interoperability endpoints

• Direct secure messaging: mroberts10889@mhsdirect.net
• FHIR API: https://api.platform.athenahealth.com/13023/brand/4/csg/1/fhir/r4

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.

• Radiology Associates of Hollywood, Inc.

  • Diagnostic Radiology Physician
  • South Miami, FL
  • NPI 1992191928
  NPD (past)
• Sunrise Medical Group Inc

  • Neurology Physician
  • Hollywood, FL
  • NPI 1912957697

  Diagnostic Radiology

  NPD (past)

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1770586877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3620 N 55TH AVE",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330212344",
            "telephone_number": "954-964-8480",
            "fax_number": "754-400-8543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3620 N 55TH AVE",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330212344",
            "telephone_number": "954-964-8480",
            "fax_number": "754-400-8543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "deactivation_date": "2016-06-13",
        "reactivation_date": "2016-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME55375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "09847",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "064827200",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mroberts10889@MHSDIRECT.NET",
            "affiliation": "N",
            "address_1": "3620 N 55th Ave",
            "city": "Hollywood",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330212344",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Robert Reid Jr MD PA
• Robert S Mahler MD PA
• Roberto a Cano, M.D., P.a.
• Roberts Group Home Inc.
• Jonathan S Roberts, MD
• Colin Robins, DC
• James T Robinson, CRNA
• Lindsey Brianne Robinson, PA-C
• Mary Alexis Robinson, ARNP
• Randesha Marvaeauna Robinson, LMT

• Diagnostic Radiology Physician in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Diagnostic Radiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; 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.