Individual provider Active NPI

Trent Roubleau, M.D.

  • Neurology Physician
  • Richmond, VA
National Provider Identifier
1831624295
Registry record updated Jun 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
T7342 Issued in TX
Practice address
2114 Maplewood Ave
Richmond, VA 23220
Phone
(832) 618-4214
NPI assigned
Apr 24, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X T7342 TX Primary

Addresses

Primary practice location

2114 Maplewood Ave
Richmond, VA 23220

Mailing address

1053 Clove Hitch Rd
Georgetown, TX 78633-2089
Phone (832) 618-4214

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20220708002646 TX Practitioner - PsychiatryPractitioner - Neurology 5496024556 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Neurology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carepoint Inpatient Blue Sky Neurology - Texas, PLLCGroup PAC ID 1557776036, 39 clinicians

Practice addresses (Care Compare)

1139 E Sonterra Blvd
San Antonio, TX 78258-4347
Phone (210) 638-2000

2400 Round Rock Ave
Round Rock, TX 78681-4004
Phone (512) 341-1000

Hospital & facility affiliations

  • Round Rock Medical Center Hospital, Round Rock, TX, CCN 450718

National Provider Directory

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

Organizations & group practices 1

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": "1492992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655337600000",
    "number": "1831624295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1053 CLOVE HITCH RD",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786332089",
            "telephone_number": "832-618-4214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2114 MAPLEWOOD AVE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "23220",
            "telephone_number": "832-618-4214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUBLEAU",
        "first_name": "TRENT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-24",
        "last_updated": "2022-06-16",
        "certification_date": "2022-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TX",
            "license": "T7342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.