NPIMap

Individual provider Active NPI

Phillip David Roberts, DO

  • Family Medicine Physician
  • Portsmouth, OH
National Provider Identifier
1871742338
Registry record updated Dec 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34009451 Issued in OH
Practice address
1248 Kinneys LN
Portsmouth, OH 45662-2927
Phone
(740) 356-7290
Fax
(740) 356-7938
NPI assigned
Sep 9, 2008
Last updated
Dec 15, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34009451 OH Primary

Addresses

Primary practice location

1248 Kinneys LN
Portsmouth, OH 45662-2927

Mailing address

1735 27TH St Ste B06
Portsmouth, OH 45662-2681
Phone (740) 356-8681

Other identifiers 1

IdentifierTypeStateIssuer
2958410MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address phillip.roberts@somc.medicity.net

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091103000194 OH Practitioner - Family Practice 9234276726 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ohio University, College of Osteopathic Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Therapy and Health Centers IncGroup PAC ID 7416859574, shared by 6 NPIs, 263 clinicians

Practice addresses (Care Compare)

1248 Kinneys LN
Portsmouth, OH 45662-2927
Phone (740) 356-7290

1735 27TH St
Portsmouth, OH 45662-2679
Phone (740) 356-8822

1805 27TH St
Portsmouth, OH 45662-2640
Phone (740) 356-8117

7700 Ohio River Rd
Suite B
Wheelersburg, OH 45694-1653
Phone (740) 574-4616

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.59 of 100Reported as group
Quality
59.57
Promoting interoperability
100
Improvement activities
40
Cost
71.16

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue213
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34009451OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Somc Medical Care Foundation, Inc. Current Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

1735 27th St
Ste B06
Portsmouth, OH 45662
Phone (740) 356-7942

1805 27th St
Portsmouth, OH 45662
Phone (740) 356-5000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1220918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1871742338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1735 27TH ST STE B06",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456622681",
            "telephone_number": "740-356-8681",
            "fax_number": "740-353-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1248 KINNEYS LN",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456622927",
            "telephone_number": "740-356-7290",
            "fax_number": "740-356-7938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "PHILLIP",
        "middle_name": "DAVID",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-09",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34009451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2958410",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "phillip.roberts@somc.medicity.net",
            "affiliation": "N",
            "address_1": "1248 Kinneys Ln",
            "city": "Portsmouth",
            "state": "OH",
            "country_code": "US",
            "postal_code": "456622927",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portsmouth, OH

Sources for this page

Verify at the official NPI Registry.