NPIMap

Individual provider Active NPI

Nathan Roberts, MD

  • Emergency Medicine Physician
  • Charleston, SC
National Provider Identifier
1811519556
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
4301509005 Issued in MI
Practice address
171 Ashley Ave
Charleston, SC 29425-5305
Phone
(843) 792-1414
Fax
(734) 763-9298
NPI assigned
May 15, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4301509005 MI Primary
Student in an Organized Health Care Education/Training Program 390200000X MI

Addresses

Primary practice location

171 Ashley Ave
Charleston, SC 29425-5305

Mailing address

1500 E. Medical Center Dr.
B1-380 Taubman Center
Ann Arbor, MI 48109-5305
Phone (734) 763-7919

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, SC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230804000652 MI Practitioner - Emergency Medicine 2062834732 Reassigns benefits to 2 organizations
I20240208000973 SC Practitioner - Emergency Medicine 2062834732 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

171 Ashley Ave
Charleston, SC 29425-8908
Phone (843) 792-1414

Hospital & facility affiliations

  • Musc Medical Center Hospital, Charleston, SC, CCN 420004

Merit-based Incentive Payment System (MIPS)

Final score
79.02 of 100Reported as group
Quality
62.41
Promoting interoperability
99
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
92.11 of 100Reported as group
Quality
81.85
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301509005MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ecs Central Michigan PC Emergency Medicine CurrentSince Aug 8, 2023 Accepting new patients
University Medical Associates of the Medical University of South Carol Emergency Medicine CurrentSince Feb 1, 2024 Accepting new patients
University Medical Associates of the Medical University of South Carol CurrentSince Feb 1, 2024 Accepting new patients
University Medical Associates of the Medical University of South Carol Current Accepting new patients
Ecs Western Michigan PC Emergency Medicine CurrentSince Aug 5, 2023 Accepting new patients

Locations

100 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 391-1680

1840 Wealthy St SE
Grand Rapids, MI 49506
Phone (616) 391-1730

615 S Bower St
Greenville, MI 48838
Phone (616) 754-4341

826 W King St
Owosso, MI 48867
Phone (989) 720-2273

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

Interoperability endpoints

  • Direct secure messaging: nroberts475460@direct.musc.edu

Organizations & group practices 5

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 6

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": "1589500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1811519556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 E. MEDICAL CENTER DR.",
            "address_2": "B1-380 TAUBMAN CENTER",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095305",
            "telephone_number": "734-763-7919",
            "fax_number": "734-763-9298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 ASHLEY AVE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294255305",
            "telephone_number": "843-792-1414",
            "fax_number": "734-763-9298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "NATHAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-15",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301509005",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.