Individual provider Active NPI

Benjamin Roby, PA-C

  • Medical Physician Assistant
  • Gainesville, GA
National Provider Identifier
1942733480
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
8345 Issued in GA
Practice address
1240 Jesse Jewell Pkwy SE
Ste 300
Gainesville, GA 30501-3861
Phone
(770) 534-7200
NPI assigned
Apr 11, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 8345 GA Primary

Addresses

Primary practice location

1240 Jesse Jewell Pkwy SE
Ste 300
Gainesville, GA 30501-3861

Mailing address

1240 Jesse Jewell Pkwy SE
Ste 300
Gainesville, GA 30501-3861
Phone (770) 534-7200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address broby@specialtyorthoga.emadirect.md Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, TX2 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
I20170912000564 GA Practitioner - Physician Assistant 1456624592 Reassigns benefits to 4 organizations
I20210903002703 TX Practitioner - Physician Assistant 1456624592 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Specialty Orthopaedics PCGroup PAC ID 6305805615, 19 clinicians

Practice addresses (Care Compare)

1240 Jesse Jewell Pkwy SE
Suite 300
Gainesville, GA 30501-3861
Phone (770) 534-7200

1240 Jesse Jewell SE Pkwy
Suite 300
Gainesville, GA 30501-3861

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
008345GAMDAnesthesiology Physician
8345GAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Doctx3 PLLC CurrentSince Aug 3, 2021 Accepting new patients
Specialty Orthopaedics, PC CurrentSince Aug 1, 2022 Accepting new patients
Houston County Emergency Group, LLC CurrentSince Aug 15, 2020 Accepting new patients
Lavender Inpatient Services LLC Past Accepting new patients
Aylo Health, LLC Past Accepting new patients
Aylo Health, LLC Past Accepting new patients
Aylo Health, LLC Past Accepting new patients
Mount Lassen Emergency Physicians LLC Past Accepting new patients

Locations

1229 Friendship Rd
#100
Braselton, GA 30517
Phone (770) 532-7202

81 Prominence Ct
#100
Dawsonville, GA 30534
Phone (770) 532-7202

2320 Peachtree Industrial Blvd
Ste 103
Duluth, GA 30097
Phone (770) 532-7202

1240 Jesse Jewell Pkwy SE
Ste 300
Gainesville, GA 30501
Phone (770) 532-7202

1601 Watson Blvd
Warner Robins, GA 31093
Phone (478) 322-5155

3110 Guadalupe St
Ste 100
Austin, TX 78705
Phone (512) 599-9510

709 E Slaughter Ln
Ste 404
Austin, TX 78744
Phone (512) 277-6643

9500 Dallas Pkwy
Ste 100
Frisco, TX 75033
Phone (469) 535-6647

3014 N O Connor Rd
Ste 200
Irving, TX 75062
Phone (214) 444-5558

Interoperability endpoints

  • Direct secure messaging: broby@specialtyorthoga.emadirect.md

Organizations & group practices 11

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.

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": "1491868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1942733480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 JESSE JEWELL PKWY SE",
            "address_2": "STE 300",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013861",
            "telephone_number": "770-534-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 JESSE JEWELL PKWY SE",
            "address_2": "STE 300",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013861",
            "telephone_number": "770-534-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBY",
        "first_name": "BENJAMIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-11",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "8345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "broby@specialtyorthoga.emadirect.md",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1240 Jesse Jewell Pkwy SE Ste 300",
            "city": "Gainesville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305013861",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.