Individual provider Active NPI

Robert Mason McLennan, M.D.

  • Anesthesiology Physician
  • Roanoke, VA
National Provider Identifier
1881987188
Registry record updated Mar 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
0101257770 Issued in VA
Practice address
5115 Bernard Dr Ste 201
Roanoke, VA 24018-4367
Phone
(540) 345-0289
Fax
(540) 345-9569
NPI assigned
May 18, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 0101257770 VA Primary

Addresses

Primary practice location

5115 Bernard Dr Ste 201
Roanoke, VA 24018-4367

Mailing address

PO Box 13306
Roanoke, VA 24032-3306
Phone (540) 345-0289

Other identifiers 2

IdentifierTypeStateIssuer
1881987188MedicaidVA
1881987188MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20150717001237 VA Practitioner - Anesthesiology 0244543395 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Loma Linda University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acv IncGroup PAC ID 3870633936, 70 clinicians

Practice addresses (Care Compare)

101 Elm Ave
Roanoke, VA 24013-2230
Phone (540) 224-6780

1722 S Jefferson St
Roanoke, VA 24014-2482
Phone (540) 981-7268

2030 Stephenson Swave
Roanoke, VA 24014-1664
Phone (540) 904-6170

2107 Rosalind Swave
Roanoke, VA 24014-1745
Phone (540) 904-6170

Hospital & facility affiliations

  • Carilion Medical Center Hospital, Roanoke, VA, CCN 490024
  • Carilion Stonewall Jackson Hospital Hospital, Lexington, VA, CCN 491304

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101257770VAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Acv Inc Anesthesiology CurrentSince Aug 6, 2015 Accepting new patients
Anesthesiology Consultants of Virginia, Inc Anesthesiology PastSince Mar 9, 2020 Accepting new patients

Locations

1906 Belleview Ave SE
Roanoke, VA 24014
Phone (540) 853-0222

1102 S Jefferson St
Roanoke, VA 24016
Phone (540) 342-0707

5115 Bernard Dr
Ste 201
Roanoke, VA 24018
Phone (540) 345-0289

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.

Hospital & facility affiliations 5

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": "1305676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583366400000",
    "number": "1881987188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13306",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240323306",
            "telephone_number": "540-345-0289",
            "fax_number": "540-345-9569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5115 BERNARD DR STE 201",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240184367",
            "telephone_number": "540-345-0289",
            "fax_number": "540-345-9569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLENNAN",
        "first_name": "ROBERT",
        "middle_name": "MASON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-18",
        "last_updated": "2020-03-05",
        "certification_date": "2020-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "VA",
            "license": "0101257770",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1881987188",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1881987188",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.