Individual provider Active NPI

Robert Eric Gilbert, PA

  • Physician Assistant
  • Roosevelt, UT
National Provider Identifier
1922659762
Registry record updated Sep 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11452295-1206 Issued in UT
Practice address
431 E North Poco Dr
Roosevelt, UT 84066-3411
Phone
(435) 724-8288
NPI assigned
Sep 23, 2019
Last updated
Sep 23, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 11452295-1206 UT Primary

Addresses

Primary practice location

431 E North Poco Dr
Roosevelt, UT 84066-3411

Mailing address

431 E North Poco Dr
Roosevelt, UT 84066-3411
Phone (435) 724-8288

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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 1

Enrollment IDStateProvider typePAC IDDetails
I20200117001353 UT Practitioner - Physician Assistant 9133554207 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeastern Utah Medical GroupGroup PAC ID 2961496609, 52 clinicians

Practice addresses (Care Compare)

210 W 300
Roosevelt, UT 84066-2336
Phone (435) 722-4691

250 W 300
Roosevelt, UT 84066-2336

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.32 of 100Reported as apm
Quality
71.89
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11452295-1206UTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northeastern Utah Medical Group CurrentSince Dec 12, 2019 Accepting new patients

Locations

50 E 200 S
Duchesne, UT 84021
Phone (435) 738-2426

210 W 300 N
Roosevelt, UT 84066
Phone (435) 722-4691

475 N 500 W
Vernal, UT 84078
Phone (435) 781-2030

Organizations & group practices 2

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 3

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": "1569196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569196800000",
    "number": "1922659762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 E NORTH POCO DR",
            "city": "ROOSEVELT",
            "state": "UT",
            "postal_code": "840663411",
            "telephone_number": "435-724-8288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 E NORTH POCO DR",
            "city": "ROOSEVELT",
            "state": "UT",
            "postal_code": "840663411",
            "telephone_number": "435-724-8288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILBERT",
        "first_name": "ROBERT",
        "middle_name": "ERIC",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-23",
        "last_updated": "2019-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "11452295-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roosevelt, UT

Sources for this page

Verify at the official NPI Registry.