Marc Preston Roberts, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

25MA03289200 Issued in NJ

Practice address

559 Broad St
Newark, NJ 07102-4503

Phone

(973) 622-3890

NPI assigned

Aug 31, 2006

Sex

Male

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Marc Roberts M.D. P.a.

  • Specialist
  • Newark, NJ
  • NPI 1801956818
  Authorized official Same address or phone
• Washington Park Pediatrics

  dba KidsCare

  • Pediatrics Physician
  • Newark, NJ
  • NPI 1447311493
  Authorized official Same address or phone

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811008402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "559 BROAD ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071024503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "559 BROAD ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071024503",
            "telephone_number": "973-622-3890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "MARC",
        "middle_name": "PRESTON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MA03289200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3851800",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Treat Academy Charter School Inc
• Cha Robert, DDS
• Abgiale Alexes Roberts, FNP
• Ashley Naomi Roberts
• Dustin Geldrich Roberts
• Rhonika Roberts, LCSW
• Amir Robinson-Hagans
• Jeremiah Robinson-Hagans
• Calandra Robinson, LCADC
• Cheryl Robinson

• Specialist in Newark, NJ
• Providers in Newark, NJ by specialty
• Specialist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.