Jonathan Charles Roberts, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

125.054688 Issued in IL

Practice address

427 W Northmoor Rd
Peoria, IL 61614-3542

Phone

(309) 692-5337

Fax

(309) 693-3913

NPI assigned

Jul 16, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Pediatric MedicineAlso: Hematology/Oncology

Education

Southern Illinois University School of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

The Bleeding and Clotting Disorders InstituteGroup PAC ID 6608051230, 10 clinicians

Michael D. Tarantino, M.D. S.C.Group PAC ID 6800950833, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067
• Carle Health Methodist Hospital Hospital, Peoria, IL, CCN 140209
• St Mary Medical Center Hospital, Galesburg, IL, CCN 140064
• Graham Hospital Association Hospital, Canton, IL, CCN 141356
• Graham Hospital Association Hospital, Canton, IL, CCN 140001

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jonathan.roberts@4214.securemail.prognocis.com

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.

• Michael D. Tarantino, M.D. S.C.

  • Pediatric Hematology & Oncology Physician
  • Peoria, IL
  • NPI 1740430784
  Medicare reassignment Care Compare group NPD
• The Bleeding and Clotting Disorders Institute

  • Clinic/Center
  • Peoria, IL
  • NPI 1134424633
  Medicare reassignment Care Compare group NPD
• The Bleeding and Clotting Disorders Institute

  • Pediatric Hematology & Oncology Physician
  • Peoria, IL
  • NPI 1528925666
  NPD
• Gibson Community Hospital Association

  dba Gibson Area Hospital and Health Services

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Graham Hospital Association

  • Critical Access Hospital
  • Canton, IL
  • NPI 1154117521
  Care Compare affiliation
• Methodist Medical Center of Illinois

  • General Acute Care Hospital
  • Peoria, IL
  • NPI 1164474755
  Care Compare affiliation
• St Mary Medical Center

  dba OSF Saint Mary Medical Center

  • General Acute Care Hospital
  • Galesburg, IL
  • NPI 1164485363
  Care Compare affiliation

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

{
    "created_epoch": "1216166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627603200000",
    "number": "1871757070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "427 W NORTHMOOR RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616143542",
            "telephone_number": "309-692-5337",
            "fax_number": "309-693-3913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "427 W NORTHMOOR RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616143542",
            "telephone_number": "309-692-5337",
            "fax_number": "309-693-3913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "JONATHAN",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-16",
        "last_updated": "2021-07-30",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "55876",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "WI",
            "license": "55876",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "125.054688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1871757070",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aleetra Roberts, MD
• Brad Roberts, DO
• Dawn C Roberts, PHD
• Jeffrey B Roberts, P.A.
• Jennifer Sue Roberts, D.O.
• Micah A Roberts, DMD
• Shannon Marie Roberts, APRN
• Sarah Katherine Robertson, MA
• John Michael Robins, MD
• Jenay E Robinson, AS. BS.

• Pediatrics Physician in Peoria, IL
• Providers in Peoria, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 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.