Individual provider Active NPI

Laura Marie Robertson, MD

  • Pediatrics Physician
  • Brockton, MA
National Provider Identifier
1932196664
Registry record updated Dec 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
217107 Issued in MA
Practice address
1324 Belmont St Ste 105
Brockton, MA 02301-4435
Phone
(508) 427-6000
Fax
(508) 427-6010
NPI assigned
Sep 27, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 217107 MA Primary

Addresses

Primary practice location

1324 Belmont St Ste 105
Brockton, MA 02301-4435

Mailing address

1324 Belmont St Ste 105
Brockton, MA 02301-4435
Phone (508) 427-6000

Other identifiers 8

IdentifierTypeStateIssuer
6101419001OtherCIGNA
59977OtherFALLON
467518OtherTUFTS
AA1021OtherHPHC
2026988MedicaidMA
30195OtherBMC HEALTHNET
3388884OtherAETNA
J26849OtherBLUE CROSS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Laura.Robertson.CHP@direct.partners.masshiway.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Associates Inc. of Brockton Pediatrics Current Accepting new patients
Cedar Hill Pediatrics LLC Pediatrics CurrentSince Dec 26, 2021 Accepting new patients
Aqeel M Siddiqui MD LTD PastSince Sep 16, 2012 Accepting new patients
J Rako MD PC Pediatrics Past Accepting new patients

Locations

1324 Belmont St
Ste 105
Brockton, MA 02301
Phone (508) 427-6000

Interoperability endpoints

  • Direct secure messaging: laura.robertson.chp@direct.partners.masshiway.net
  • Direct secure messaging: robertson.laura.pbroc@direct.partners.masshiway.net

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640131200000",
    "number": "1932196664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 BELMONT ST STE 105",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014435",
            "telephone_number": "508-427-6000",
            "fax_number": "508-583-7599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1324 BELMONT ST STE 105",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014435",
            "telephone_number": "508-427-6000",
            "fax_number": "508-427-6010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "LAURA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-27",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "217107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6101419001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON",
            "identifier": "59977",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "467518",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HPHC",
            "identifier": "AA1021",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2026988",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BMC HEALTHNET",
            "identifier": "30195",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3388884",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "J26849",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Laura.Robertson.CHP@direct.partners.masshiway.net",
            "affiliation": "N",
            "address_1": "1324 Belmont St Ste 105",
            "city": "Brockton",
            "state": "MA",
            "country_code": "US",
            "postal_code": "023014435",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.