Paul Joseph Roberts, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

20040614A Issued in IN

Practice address

4043 S Webster St
Kokomo, IN 46902-6911

Phone

(765) 450-8204

Fax

(765) 450-8206

NPI assigned

Jun 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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.

• Indiana Neuropsychological Services LLC

  • Adult Mental Health Clinic/Center
  • Kokomo, IN
  • NPI 1275760696
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1922042647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4043 S WEBSTER ST",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469026911",
            "telephone_number": "765-450-8204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4043 S WEBSTER ST",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469026911",
            "telephone_number": "765-450-8204",
            "fax_number": "765-450-8206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "PAUL",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20040614A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100269030A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert a. Clements, D.C., P.C.
• Roberts Dental Group LLC
• Amanda Roberts, PMHNP
• Justin L Roberts, D.D.S.
• Lindsey Carol Roberts, FNP
• Lori Annette Robertson, LCSW, LCAC
• James Robinson, RPT
• Makayla Lee Robison
• Madison Rodabaugh
• Jamie Susan Rosalva Rodriguez, LMHC-A

• Clinical Psychologist in Kokomo, IN
• Providers in Kokomo, IN by specialty
• Clinical Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; 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.

Verify at the official NPI Registry.