Tara L Robertson, MS.,PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

2750 Issued in WI

Practice address

301 E Saint Joseph St
Green Bay, WI 54301-2241

Phone

(920) 433-3630

NPI assigned

Mar 6, 2007

Sex

Female

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 2

Medicare fee-for-service enrollment

Enrolled in WI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: trobertson925723@direct.emplifyhealth.org

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.

• Bellin Memorial Hospital Inc

  • Rural Health Clinic/Center
  • Algoma, WI
  • NPI 1609838473

  WI

  Medicare reassignment Care Compare group NPD
• Bellin Psychiatric Center Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Green Bay, WI
  • NPI 1952554800

  WI

  Medicare reassignment NPD
• Bellin Memorial Hospital Inc

  • Family Medicine Physician
  • Green Bay, WI
  • NPI 1033172390
  Care Compare group NPD
• Bellin Memorial Hospital Inc

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Green Bay, WI
  • NPI 1518920883
  Care Compare group
• Bellin Memorial Hospital Inc

  • Home Infusion Therapy Pharmacy
  • Green Bay, WI
  • NPI 1619078094
  Care Compare group
• Bellin Memorial Hospital Inc

  • Rural Health Clinic/Center
  • Kewaunee, WI
  • NPI 1699737379
  Care Compare group
• Bellin Memorial Hospital Inc

  • Mobile Radiology Clinic/Center
  • Green Bay, WI
  • NPI 1740600600
  Care Compare group
• Bellin Memorial Hospital Inc

  • Home Health Agency
  • Green Bay, WI
  • NPI 1831246404
  Care Compare group
• Bellin Memorial Hospital Inc.

  • General Acute Care Hospital
  • Green Bay, WI
  • NPI 1891740585
  Care Compare group
• Bellin Memorial Hospital, Inc

  • Rehabilitation Hospital Unit
  • Green Bay, WI
  • NPI 1174689178
  Care Compare group
• Bellin Memorial Hospital Inc

  • Cardiovascular Disease Physician
  • Crystal Falls, MI
  • NPI 1376649509
  Care Compare group
• Bellin Memorial Hospital Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • Green Bay, WI
  • NPI 1679983183
  NPD

Specialty

Clinical Psychologist

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bellin Memorial Hospital Inc 685 clinicians

Practice addresses (Care Compare)

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612915200000",
    "number": "1831229376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 E SAINT JOSEPH ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543012241",
            "telephone_number": "920-433-3630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E SAINT JOSEPH ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543012241",
            "telephone_number": "920-433-3630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "TARA",
        "middle_name": "L",
        "credential": "MS.,PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2021-02-10",
        "certification_date": "2021-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "2750",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1831229376",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43596700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda J Robertson, PA-C
• Bruce J. Robertson, PHD
• Cheryl M Robertson
• Mary E Robertson, APNP
• Savana Lorron Robertson
• Tyler Robertson
• Bethany A Robinson, BA
• Brock Lyndsey Robinson, MD
• Charmin Robinson
• Christopher Michael Robinson, APRN, CRNA, DNAP

• All providers in Green Bay, WI
• Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.