Dudley Roberts III, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

DR051585 Issued in MI

Practice address

18245 E 10 Mile Rd
Roseville, MI 48066-5807

Phone

(586) 774-8710

NPI assigned

Sep 20, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in MI

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.

Enrollment records 1

Specialty

Internal Medicine

Education

Wayne State University School of Medicine, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Complete Care Rehab LLCGroup PAC ID 2466423637, 12 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Beaumont Hospital - Grosse Pointe Hospital, Grosse Pointe, MI, CCN 230089
• Henry Ford Health St John Hospital Hospital, Detroit, MI, CCN 230165

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: droberts1149267@direct.hfhs.org

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.

• Dudley Roberts M.D, L.L.C.

  • Internal Medicine Physician
  • Roseville, MI
  • NPI 1356377501
  Medicare reassignment Authorized official
• Complete Care Rehab LLC

  • Rehabilitation Hospital Unit
  • Saint Clair Shores, MI
  • NPI 1801844220
  Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• William Beaumont Hospital

  • Hospitalist Physician
  • Royal Oak, MI
  • NPI 1811044878
  Care Compare affiliation
• William Beaumont Hospital

  dba Beaumont Hospital, Grosse Pointe

  • General Acute Care Hospital
  • Grosse Pointe, MI
  • NPI 1932396017
  Care Compare affiliation
• Henry Ford Health St. John Hospital

  dba St John Hospital and Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1023088168
  Care Compare affiliation

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383264000000",
    "number": "1922094507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18245 E 10 MILE RD",
            "address_2": "SUITE 120",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480665807",
            "telephone_number": "586-774-8710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18245 E 10 MILE RD",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480665807",
            "telephone_number": "586-774-8710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "DUDLEY",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2013-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "DR051585",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMR",
            "identifier": "110227501",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS",
            "identifier": "1105015902",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104715716",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PPOM",
            "identifier": "383712316",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN",
            "identifier": "P115806",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Toni Ristovski
• Rite Aid
• Rebecca A Rivard, D.O.
• Robert E Brinker OD,PC
• Robert L Marchese MD Diseases of the Lung PLLC
• Terri Elizabeth Robertson, LPN
• Sherry Robida, LLBSW
• Robin Samyn, MD PLLC
• Robinson Hearing Centers LLC
• Rebecca Robinson

• Internal Medicine Physician in Roseville, MI
• Providers in Roseville, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2013; 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.