Active NPI
Charles R Roberts, M.D.
- Ophthalmology Physician
- Worcester, MA
National Provider Identifier
1881884914
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 29902
- Practice address
- 25 Oak Ave
Worcester, MA 01605-2751 - Phone
- (508) 755-2136
- NPI assigned
- Jul 25, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 29902 | MA | Primary |
Addresses
Primary practice location
25 Oak Ave
Worcester, MA 01605-2751
Mailing address
25 Oak Ave
Worcester, MA 01605-2751
Phone (508) 755-2136
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29902 | MA | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185321600000",
"number": "1881884914",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 OAK AVE",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016052751",
"telephone_number": "508-755-2136"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 OAK AVE",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016052751",
"telephone_number": "508-755-2136"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "CHARLES",
"middle_name": "R",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-25",
"last_updated": "2007-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "MA",
"license": "29902",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.