Individual provider Active NPI

Benjamin Bradley Roberts, M.D.

  • Pediatric Anesthesiology Physician
  • Birmingham, AL
National Provider Identifier
1790104446
Registry record updated Feb 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Anesthesiology PhysicianTaxonomy code 207LP3000X
License
34543 Issued in AL
Practice address
1600 7TH Ave S # 420
Birmingham, AL 35233-1711
Phone
(205) 638-9235
Fax
(205) 638-9936
NPI assigned
Apr 9, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 34543 AL
Pediatric Anesthesiology Physician 207LP3000X 34543 AL Primary

Addresses

Primary practice location

1600 7TH Ave S # 420
Birmingham, AL 35233-1711

Mailing address

1600 7TH Ave S # 420
Birmingham, AL 35233-1711
Phone (205) 638-9235

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20210528000274 AL Practitioner - Anesthesiology 3173746971 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Alabama School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pediatric Anesthesia Associates PCGroup PAC ID 5395719025, 16 clinicians

Practice addresses (Care Compare)

1600 7TH Ave S
Lowder 420
Birmingham, AL 35233-1711
Phone (205) 939-9235

Hospital & facility affiliations

  • The Children'S Hospital of Alabama Hospital, Birmingham, AL, CCN 013300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34543ALMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Anesthesia Associates PC Anesthesiology CurrentSince Feb 12, 2021 Accepting new patients
University of Alabama Health Services Foundation, PC. Past Accepting new patients

Locations

1600 7th Ave S
#420888888888888888888888888888888
Birmingham, AL 35233

1600 7th Ave S
#420
Birmingham, AL 35233
Phone (205) 638-9235

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1397001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675209600000",
    "number": "1790104446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 7TH AVE S # 420",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331711",
            "telephone_number": "205-638-9235",
            "fax_number": "205-638-9936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 7TH AVE S # 420",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331711",
            "telephone_number": "205-638-9235",
            "fax_number": "205-638-9936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "BENJAMIN",
        "middle_name": "BRADLEY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-09",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AL",
            "license": "34543",
            "primary": false
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "AL",
            "license": "34543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.