Caley Roberts, PA
Individual provider Active NPI Physician Assistant · Scott City, KS
NPI 1902200355 · NPPES record last updated Dec 29, 2017
Key facts
- NPI
- 1902200355
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 1501750 (KS)
- Practice address
- 201 Albert Ave
Scott City, KS 67871 - Phone
- (620) 872-2187
- Fax
- (620) 872-7193
- NPI assigned
- Oct 14, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Medicare Care Compare profile
Merit-based Incentive Payment System (MIPS)
- Final score
- 94.7 of 100
- Quality
- 89.4
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220912002781 | SC | Practitioner - Physician Assistant | 2668794835 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4466 | SC | MD | Pharmacist |
| 1501750 | KS | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spartanburg Medical Center | Current |
Accepting new patients | |
| Pelham Medical Center | Current |
Accepting new patients | |
| Spartanburg Medical Center | Current |
Accepting new patients | |
| Village Hospital | Past | Accepting new patients | |
| Spartanburg Medical Center | Past | Accepting new patients |
Locations
250 Westmoreland Rd
Greer, SC 29651
Phone (864) 530-2108
101 E Wood St
Spartanburg, SC 29303
Phone (864) 560-1915
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 15-01750 | KS | |
| Physician Assistant | 363A00000X | 1501750 | KS | Yes |
Addresses
Primary practice location
201 Albert Ave
Scott City, KS 67871
Mailing address
201 Albert Ave
Scott City, KS 67871
Phone (620) 872-2187
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201106490A | Medicaid | KS |
Other providers in Scott City, KS
- Prohealth Chiropractic Wellness Centers, PA
- Charles J. Purma II
- Viridiana Madrid Riddle
- Mackenzie Kate Ritter
- Kelly Sue Robbins
- Jena Robertson Brunswig
- Delfin A Sarmiento
- Hannah Marie Scheetz
- Scott City Chiropractic Clinic, LLC
- Scott City Pharmacy
All providers in Scott City, KS · Physician Assistant in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 29, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.