Bruce Allen Roberts, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

C53920 Issued in CA

Practice address

2443 Fillmore St # 380-3991
San Francisco, CA 94115-1814

Phone

(415) 964-0546

Fax

(888) 861-2143

NPI assigned

Jun 13, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Dec 1, 2015 through Dec 1, 2027

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Lighthearted Medicine, Inc.

  • Health Service Clinic/Center
  • San Francisco, CA
  • NPI 1982151676
  NPD (past) Authorized official
• Synchronicity Center, PLLC

  • Psychiatry Physician
  • Tucson, AZ
  • NPI 1700824620

  Family Medicine

  NPD (past) Authorized official
• Lafrontera Center Inc

  • Methadone Clinic
  • Tucson, AZ
  • NPI 1548361470
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1912940305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2443 FILLMORE ST # 380-3991",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941151814",
            "telephone_number": "415-964-0546",
            "fax_number": "888-861-2143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2443 FILLMORE ST # 380-3991",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941151814",
            "telephone_number": "415-964-0546",
            "fax_number": "888-861-2143"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2300 California St",
            "address_2": "#103",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941152753",
            "country_code": "US",
            "telephone_number": "916-854-6975",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "BRUCE",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "14557",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AZ",
            "license": "14557",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "C53920",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "C53920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Liesel Roberts Derfield, MFT
• Eleanor Roberts-Hosley, AMFT
• Alexandra Roberts, MOT, OTR/L
• Andrew Scott Roberts, M.D.
• Angela K. Roberts
• Caroline Roberts, M.D.
• Celia A Roberts
• Daniel Edward Roberts II
• Elisabeth Weiss Roberts, RN, IBCLC
• Gerald S. Roberts, M.D.

• Family Medicine Physician in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.