Individual provider Active NPI

Jarrod Robertson

  • Surgery Physician
  • Tallahassee, FL
National Provider Identifier
1790218295
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME154730 Issued in FL
Practice address
1405 Centerville Rd Ste 4400
Tallahassee, FL 32308-4622
Phone
(850) 877-6212
NPI assigned
Apr 11, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X ME154730 FL Primary

Addresses

Primary practice location

1405 Centerville Rd Ste 4400
Tallahassee, FL 32308-4622

Mailing address

4700 Waters Ave
Savannah, GA 31404-6220
Phone (912) 350-8598

Other practice location 1

4700 Waters Ave
Savannah, GA 31404-6220
Phone (912) 350-8598

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230719001263 FL Practitioner - General Surgery 2567720469 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Florida State University College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1300 Miccosukee Rd
Tallahassee, FL 32308-5054
Phone (850) 877-5183

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy43
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME154730FLMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tallahassee Memorial Healthcare Inc Current Accepting new patients
Tallahassee Memorial Healthcare Inc Current Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

1607 Saint James Ct
Ste 1
Tallahassee, FL 32308
Phone (850) 431-7021

1300 Miccosukee Rd
Tallahassee, FL 32308
Phone (850) 431-1155

Interoperability endpoints

  • Direct secure messaging: jrobertson22103@tallahasseememorial.direct-ci.com
  • Direct secure messaging: jarrodrobertson@tmhpp.allscriptsdirect.net

Organizations & group practices 3

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": "1491868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1790218295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 WATERS AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314046220",
            "telephone_number": "912-350-8598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 CENTERVILLE RD STE 4400",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084622",
            "telephone_number": "850-877-6212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4700 Waters Ave",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314046220",
            "country_code": "US",
            "telephone_number": "912-350-8598",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "JARROD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-11",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME154730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.