Individual provider Active NPI

Robert L McRoberts, PHD

  • Psychologist
  • Lenexa, KS
National Provider Identifier
1790701696
Registry record updated Jan 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
0747 Issued in KS
Practice address
8629 Bluejacket St
Suite 100
Lenexa, KS 66214
Phone
(913) 677-3553
Fax
(913) 677-3282
NPI assigned
Jul 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 01197 MO
Psychologist 103T00000X 0747 KS Primary

Addresses

Primary practice location

8629 Bluejacket St
Suite 100
Lenexa, KS 66214

Mailing address

8629 Bluejacket St
Suite 100
Lenexa, KS 66214
Phone (913) 677-3553

Other identifiers 2

IdentifierTypeStateIssuer
100239960DMedicaidKS
493241400MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140731000723 KS Practitioner - Clinical Psychologist 3274531199 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
University of Kansas School of Med (KC/Wich/Sal), 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Clinical Associates PAGroup PAC ID 9739084112, 23 clinicians

Practice addresses (Care Compare)

8629 Bluejacket St
Lenexa, KS 66214-1604
Phone (913) 677-3553

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01197MOMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Associates PA CurrentSince May 18, 2014 Accepting new patients
Children'S Psychological Services Inc. Psychologist PastSince Jan 1, 1990 Accepting new patients

Locations

8629 Bluejacket St
Ste 100
Overland Park, KS 66214
Phone (913) 677-3553

8629 Bluejacket St
Overland Park, KS 66214
Phone (913) 677-3553

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.

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421712000000",
    "number": "1790701696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8629 BLUEJACKET ST",
            "address_2": "SUITE 100",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "66214",
            "telephone_number": "913-677-3553",
            "fax_number": "913-677-3282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8629 BLUEJACKET ST",
            "address_2": "SUITE 100",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "66214",
            "telephone_number": "913-677-3553",
            "fax_number": "913-677-3282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCROBERTS",
        "first_name": "ROBERT",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2015-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MO",
            "license": "01197",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "KS",
            "license": "0747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100239960D",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "493241400",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lenexa, KS

Sources for this page

Verify at the official NPI Registry.