Individual provider Active NPI

Robert M. Dewitt, M.D.

  • Diagnostic Radiology Physician
  • Lackland Afb, TX
National Provider Identifier
1861603284
Registry record updated Apr 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
P4642 Issued in TX
Practice address
2200 Bergquist Dr
Lackland Afb, TX 78236-9907
Phone
(210) 292-5282
NPI assigned
May 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 0101243215 VA
Diagnostic Radiology Physician 2085R0202X P4642 TX Primary

Addresses

Primary practice location

2200 Bergquist Dr
Lackland Afb, TX 78236-9907

Mailing address

9414 Mariposa Pass
San Antonio, TX 78251-4984
Phone (804) 677-4259

Other practice location 1

2001 N Jefferson Ave
Mount Pleasant, TX 75455-2338
Phone (903) 577-6000

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
I20220807000000 TX Practitioner - Diagnostic Radiology 3678741873 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P4642TXMDDiagnostic Radiology Physician
0101243215VAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Titus County Hospital District Past Accepting new patients
University of Virginia Physicians Group PastSince Nov 1, 2017 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777248000000",
    "number": "1861603284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9414 MARIPOSA PASS",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782514984",
            "telephone_number": "804-677-4259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 BERGQUIST DR",
            "city": "LACKLAND AFB",
            "state": "TX",
            "postal_code": "782369907",
            "telephone_number": "210-292-5282"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2001 N Jefferson Ave",
            "address_purpose": "LOCATION",
            "city": "Mount Pleasant",
            "state": "TX",
            "postal_code": "754552338",
            "country_code": "US",
            "telephone_number": "903-577-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEWITT",
        "first_name": "ROBERT",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-25",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "0101243215",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "P4642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lackland Afb, TX

Sources for this page

Verify at the official NPI Registry.