Individual provider Active NPI

Jonathan Jerard Roberts, M.D.

  • Internal Medicine Physician
  • Hammond, LA
National Provider Identifier
1881751667
Registry record updated Dec 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
021278 Issued in LA
Practice address
2240 W Thomas St
Hammond, LA 70401-2828
Phone
(985) 348-6139
Fax
(877) 870-5503
NPI assigned
Jan 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2021

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 021278 LA Primary

Addresses

Primary practice location

2240 W Thomas St
Hammond, LA 70401-2828

Mailing address

2240 W Thomas St
Hammond, LA 70401-2828
Phone (985) 348-6139

Other identifiers 4

IdentifierTypeStateIssuer
1930628OtherLAINTERNAL MEDICINE
1930628MedicaidLA
021278OtherLAM.D. LICENSE
721511296OtherEMPLOYER TAX ID

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jonathan.roberts@centerwell.eclinicaldirectplus.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20060330000001 LA Practitioner - Internal Medicine 5496763690 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Louisiana State University School of Medicine in New Orleans, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2240 W Thomas St
Hammond, LA 70401-2828
Phone (985) 348-6139

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
021278LAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Centerwell Senior Primary Care (la) PC Internal Medicine CurrentSince Aug 23, 2021 Accepting new patients
Centerwell Senior Primary Care (la) PC Internal Medicine Current Accepting new patients
Centerwell Senior Primary Care (la) PC Internal Medicine CurrentSince Aug 23, 2021 Accepting new patients
Centerwell Senior Primary Care (la) PC Internal Medicine Past Accepting new patients

Locations

2900 E Texas St
Ste 100
Bossier City, LA 71111
Phone (318) 606-6737

2314 S Range Ave
Denham Springs, LA 70726
Phone (225) 480-4080

2240 W Thomas St
Hammond, LA 70401
Phone (985) 348-6139

Interoperability endpoints

  • Direct secure messaging: jonathan.roberts.1@29601.direct.athenahealth.com
  • Direct secure messaging: jonathan.roberts@centerwell.eclinicaldirectplus.com

Organizations & group practices 4

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": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639612800000",
    "number": "1881751667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2240 W THOMAS ST",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704012828",
            "telephone_number": "985-348-6139",
            "fax_number": "877-870-5503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 W THOMAS ST",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704012828",
            "telephone_number": "985-348-6139",
            "fax_number": "877-870-5503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "JONATHAN",
        "middle_name": "JERARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "021278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTERNAL MEDICINE",
            "identifier": "1930628",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1930628",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "M.D. LICENSE",
            "identifier": "021278",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPLOYER TAX ID",
            "identifier": "721511296",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jonathan.roberts@centerwell.eclinicaldirectplus.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2240 W Thomas St",
            "city": "Hammond",
            "state": "LA",
            "country_code": "US",
            "postal_code": "704012828",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hammond, LA

Sources for this page

Verify at the official NPI Registry.