Individual provider Active NPI

Carla Delle Roberts, M.D.

  • Reproductive Endocrinology Physician
  • Cumming, GA
National Provider Identifier
1962435859
Registry record updated Nov 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X
License
41061 Issued in GA
Practice address
1800 Northside Forsyth Dr
Ste 380
Cumming, GA 30041
Phone
(770) 292-2670
Fax
(770) 292-2671
NPI assigned
Jul 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Reproductive Endocrinology Physician 207VE0102X 41061 GA Primary

Addresses

Primary practice location

1800 Northside Forsyth Dr
Ste 380
Cumming, GA 30041

Mailing address

1800 Northside Forsyth Dr
Ste 380
Cumming, GA 30041
Phone (770) 292-2670

Other identifiers 1

IdentifierTypeStateIssuer
000833115FMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20100122000644 GA Practitioner - Obstetrics/Gynecology 6406998889 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Emory University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northside Surgical Professional Services LLCGroup PAC ID 8628253424, 367 clinicians

Practice addresses (Care Compare)

1800 Northside Forsyth Dr
Suite 380
Cumming, GA 30041-8416
Phone (770) 292-2670

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41061GAMDReproductive Endocrinology Physician

Organizations & group practices 1

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479427200000",
    "number": "1962435859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 NORTHSIDE FORSYTH DR",
            "address_2": "STE 380",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "30041",
            "telephone_number": "770-292-2670",
            "fax_number": "770-292-2671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 NORTHSIDE FORSYTH DR",
            "address_2": "STE 380",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "30041",
            "telephone_number": "770-292-2670",
            "fax_number": "770-292-2671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "CARLA",
        "middle_name": "DELLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2016-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "GA",
            "license": "41061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000833115F",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

Verify at the official NPI Registry.