Individual provider Active NPI

Kenneth Wayne Roberts, MD

  • Emergency Medicine Physician
  • Aventura, FL
National Provider Identifier
1801359559
Registry record updated Apr 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME153623 Issued in FL
Practice address
Aventura Hospital & Medical Center
20900 Biscayne Blvd
Aventura, FL 33138
Phone
(305) 682-7000
NPI assigned
Apr 10, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207P00000X ME153623 FL Primary

Addresses

Primary practice location

Aventura Hospital & Medical Center
20900 Biscayne Blvd
Aventura, FL 33138

Mailing address

18071 Biscayne Blvd Apt 1003
Aventura, FL 33160-5230
Phone (704) 609-5454

Other names 1

  • Dr. Ken Wayne Roberts Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220513002376 FL Practitioner - Emergency Medicine 6507243474 Reassigns benefits to 2 organizations
I20220725000101 TX Practitioner - Emergency Medicine 6507243474 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paragon Contracting Services LLCGroup PAC ID 3971417825, 404 clinicians

Practice addresses (Care Compare)

2001 W 66TH St
Hialeah, FL 33016-1801
Phone (305) 364-2100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME153623FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sterling Emergency Services of Florida PA Single Specialty Current Accepting new patients
Emergency Medicine Services of TX, PLLC Single Specialty CurrentSince Aug 1, 2023 Accepting new patients
Sterling Emergency Services of Florida PA Emergency Medicine CurrentSince Apr 22, 2024 Accepting new patients
Paragon Contracting Services LLC Single Specialty CurrentSince Jul 1, 2022 Accepting new patients

Locations

2815 S Seacrest Blvd
Boynton Beach, FL 33435
Phone (561) 732-1277

9655 Boynton Beach Blvd
Boynton Beach, FL 33472
Phone (561) 336-7000

651 E 25th St
Hialeah, FL 33013
Phone (305) 835-4370

901 45th St
Mangonia Park, FL 33407
Phone (561) 844-6300

2001 W 68th St
Miami Lakes, FL 33016
Phone (305) 364-2151

1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325

225 E Parkwood Ave
Friendswood, TX 77546
Phone (281) 549-9400

22475 Tomball Pkwy
Houston, TX 77070
Phone (281) 320-5800

11100 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 770-7000

7700 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-5564

9211 Potranco Rd
San Antonio, TX 78251
Phone (210) 575-9211

26306 Kuykendahl Rd
Tomball, TX 77375
Phone (346) 246-7700

Organizations & group practices 4

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": "1554854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648857600000",
    "number": "1801359559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18071 BISCAYNE BLVD APT 1003",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331605230",
            "telephone_number": "704-609-5454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVENTURA HOSPITAL & MEDICAL CENTER",
            "address_2": "20900 BISCAYNE BLVD",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "33138",
            "telephone_number": "305-682-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "KENNETH",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-10",
        "last_updated": "2022-04-02",
        "certification_date": "2022-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME153623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KEN",
            "last_name": "ROBERTS",
            "middle_name": "WAYNE",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Aventura, FL

Sources for this page

Verify at the official NPI Registry.