Active NPI
Derrick Scott Robertson, M.D.
- Neurology Physician
- Tampa, FL
National Provider Identifier
1912169376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- ME113374
- Practice address
- 13330 Usf Laurel Drive
Tampa, FL 33612-6601 - Phone
- (813) 974-3541
- Fax
- (813) 974-9145
- NPI assigned
- Jun 27, 2008
- 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 |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | ME113374 | FL | Primary |
Addresses
Primary practice location
13330 Usf Laurel Drive
Tampa, FL 33612-6601
Mailing address
PO Box 917770
Orlando, FL 32891-7770
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 007186600 | Medicaid | FL | |
| 14NQ3 | Other | FL | BLUE CROSS BLUE SHIELD |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | drobertson6608@direct.tgh.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Neurology
- Education
- University of South Florida College of Medicine, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
13330 Usf Laurel Dr
Tampa, FL 33612-6601
Hospital & facility affiliations
- Tampa General Hospital
- Sarasota Memorial Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME113374 | FL | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Medical Service Association Inc | Neurology | Current | Accepting new patients |
| University Medical Service Association Inc | Current | Accepting new patients | |
| Tampa General Hospital | Current | Accepting new patients | |
| University Medical Service Association Inc | Current | Accepting new patients | |
| University Medical Service Association Inc | Neurology | Past | Accepting new patients |
Locations
12901 Bruce B Downs Blvd
#19
Tampa, FL 33612
Phone (813) 844-4103
13330 Usf Laurel Dr
Tampa, FL 33612
Phone (813) 396-9478
12901 Bruce B Downs Blvd
#62
Tampa, FL 33612
Networks
- Freedom Health HMO Network
Interoperability endpoints
- drobertson6608@direct.tgh.org
- https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
Organizations & group practices 5
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.
-
- Physical Therapist
- Tampa, FL
- NPI 1992742324
-
- General Acute Care Hospital
- Tampa, FL
- NPI 1124558929
-
- Durable Medical Equipment & Medical Supplies
- Tampa, FL
- NPI 1194276576
-
- Neurology Physician
- Tampa, FL
- NPI 1386684223
-
- Neurological Surgery Physician
- Tampa, FL
- NPI 1740227966
Neurology
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Tampa, FL
- NPI 1235196510
-
- General Acute Care Hospital
- Sarasota, FL
- NPI 1245294826
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617580800000",
"number": "1912169376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 917770",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328917770"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13330 USF LAUREL DRIVE",
"city": "TAMPA",
"state": "FL",
"postal_code": "336126601",
"telephone_number": "813-974-3541",
"fax_number": "813-974-9145"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTSON",
"first_name": "DERRICK",
"middle_name": "SCOTT",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-06-27",
"last_updated": "2021-04-05",
"certification_date": "2021-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "FL",
"license": "ME113374",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "007186600",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "14NQ3",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "drobertson6608@direct.tgh.org",
"affiliation": "N",
"address_1": "13330 USF Laurel Drive",
"city": "Tampa",
"state": "FL",
"country_code": "US",
"postal_code": "336126601",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.