Individual provider Active NPI

Robert Allan Roche-Barnett, MD

  • Internal Medicine Physician
  • Bayport, NY
National Provider Identifier
1881695500
Registry record updated Nov 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
176130-1 Issued in NY
Practice address
581 Middle Rd
Bayport, NY 11705-1916
Phone
(631) 472-8100
Fax
(631) 472-8811
NPI assigned
Aug 3, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 176130-1 NY Primary

Addresses

Primary practice location

581 Middle Rd
Bayport, NY 11705-1916

Mailing address

581 Middle Rd
Bayport, NY 11705-1916
Phone (631) 472-8100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20091228000444 NY Practitioner - Internal Medicine 5294875167 Reassigns benefits to 2 organizations
Practice locations: Bayport, NY

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
176130-1NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Hematology Oncology Associates PC CurrentSince Nov 1, 2022 Accepting new patients
Bellhaven Management LLC CurrentSince Mar 10, 2011 Accepting new patients

Locations

581 Middle Rd
Bayport, NY 11705
Phone (631) 472-8100

110 Beaver Dam Rd
Brookhaven, NY 11719
Phone (516) 589-4496

1500 Route 112
Bldg 4
Port Jefferson Station, NY 11776
Phone (631) 574-8354

48 Route 25A
Smithtown, NY 11787
Phone (631) 862-3540

Interoperability endpoints

  • Direct secure messaging: rroche501390@nyumc.direct-ci.com

Organizations & group practices 2

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": "1123027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258416000000",
    "number": "1881695500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "581 MIDDLE RD",
            "city": "BAYPORT",
            "state": "NY",
            "postal_code": "117051916",
            "telephone_number": "631-472-8100",
            "fax_number": "631-472-8811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "581 MIDDLE RD",
            "city": "BAYPORT",
            "state": "NY",
            "postal_code": "117051916",
            "telephone_number": "631-472-8100",
            "fax_number": "631-472-8811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROCHE-BARNETT",
        "first_name": "ROBERT",
        "middle_name": "ALLAN",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-03",
        "last_updated": "2009-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "176130-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayport, NY

Sources for this page

Verify at the official NPI Registry.