Susan J Robertson, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

30342 Issued in CO

Practice address

1420 W Midway Blvd
Broomfield, CO 80020-2090

Phone

(303) 466-1866

Fax

(303) 466-4081

NPI assigned

Jul 10, 2006

Sex

Female

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294963200000",
    "number": "1780618678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "583 W SAGEBRUSH CT",
            "city": "LOUISVILLE",
            "state": "CO",
            "postal_code": "800271644",
            "telephone_number": "303-666-8284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 W MIDWAY BLVD",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800202090",
            "telephone_number": "303-466-1866",
            "fax_number": "303-466-4081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "SUSAN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2011-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "30342",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01303429",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "R37418",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Robb Mazzant, PH.D.
• Dale Lee Roberts, DDS
• Janet M. Roberts, PH.D.
• Kristianna K. Roberts, M.D.
• Kaila Nicole Robertson, LCSW
• Jennifer Lynn Robinson, M.S.
• Mars Ray Robinson, PSY.D,M.A., L.M.F.T.
• Michele Robinson, MS OTR/L
• Reagan Rockholm
• Rocky Mountain Behavioral Medicine LLC

• Family Medicine Physician in Broomfield, CO
• Providers in Broomfield, CO by specialty
• Family Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2011; 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.