Individual provider Active NPI

Michael Patrick Roberts, PA-C

  • Physician Assistant
  • Fort Mill, SC
National Provider Identifier
1922036862
Registry record updated Oct 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-07526 Issued in NC
Practice address
601 S Sutton Rd
Ste 101
Fort Mill, SC 29715
Phone
(803) 328-6306
Fax
(803) 909-6451
NPI assigned
Jun 29, 2006
Last updated
Oct 19, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2826 SC
Physician Assistant 363A00000X 010469 NY
Physician Assistant 363A00000X 0010-07526 NC Primary

Addresses

Primary practice location

601 S Sutton Rd
Ste 101
Fort Mill, SC 29715

Mailing address

4601 Park Rd
Suite 300
Charlotte, NC 28209-3239
Phone (704) 323-2000

Other practice location 1

6 Technology Dr
Suite 100
East Setauket, NY 11733-4047
Phone (631) 689-6698

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20171127000000 NC Practitioner - Physician Assistant 0143272617 Reassigns benefits to 1 organization
I20171215001735 SC Practitioner - Physician Assistant 0143272617 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
OrthocarolinaGroup PAC ID 2062316821, 288 clinicians
Cora South Carolina LLCGroup PAC ID 3173766334, shared by 6 NPIs, 220 clinicians

Practice addresses (Care Compare)

1915 Randolph Rd
Charlotte, NC 28207-1101
Phone (704) 323-2282

2536 Lengers Way
Fort Mill, SC 29707-7126
Phone (803) 313-3294

601 Sutton Rd S
Fort Mill, SC 29715-8439
Phone (803) 328-6306

6237 Carolina Commons Dr
Suite 110
Indian Land, SC 29707-6014
Phone (803) 266-7547

851 Heckle Blvd
Rock Hill, SC 29730-2806
Phone (839) 388-0908

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2826SCMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Associates of Long Island LLP CurrentSince Jan 28, 2015 Accepting new patients
Orthocarolina Physician Assistant CurrentSince Sep 5, 2017 Accepting new patients
Orthocarolina Physician Assistant CurrentSince Sep 5, 2017 Accepting new patients
Orthocarolina Physician Assistant CurrentSince Sep 16, 2017 Accepting new patients
Orthocarolina Physician Assistant Past Accepting new patients

Locations

1915 Randolph Rd
Charlotte, NC 28207
Phone (704) 339-1000

4601 Park Rd
Ste 300
Charlotte, NC 28209
Phone (704) 323-2090

6 Technology Dr
Ste 100
East Setauket, NY 11733
Phone (631) 371-2685

601 Sutton Rd S
Ste 101
Fort Mill, SC 29715
Phone (803) 328-6303

2536 Lengers Way
Indian Land, SC 29707
Phone (803) 313-3294

197 Piedmont Blvd
Ste 111
Rock Hill, SC 29732
Phone (803) 327-3456

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697673600000",
    "number": "1922036862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 PARK RD",
            "address_2": "SUITE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282093239",
            "telephone_number": "704-323-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 S SUTTON RD",
            "address_2": "STE 101",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "29715",
            "telephone_number": "803-328-6306",
            "fax_number": "803-909-6451"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6 Technology Dr",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "East Setauket",
            "state": "NY",
            "postal_code": "117334047",
            "country_code": "US",
            "telephone_number": "631-689-6698",
            "fax_number": "631-751-5548",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "MICHAEL",
        "middle_name": "PATRICK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "2826",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "010469",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-07526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Mill, SC

Sources for this page

Verify at the official NPI Registry.