Active NPI
J Alan Robertson, MD
- Orthopaedic Surgery Physician
- Eastpointe, MI
National Provider Identifier
1972590420
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 4301049006
- Practice address
- 17200 E 10 Mile Rd
Suite 130
Eastpointe, MI 48021-3349 - Phone
- (586) 585-9047
- Fax
- (586) 585-9126
- NPI assigned
- Sep 30, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 4301049006 | MI | Primary |
Addresses
Primary practice location
17200 E 10 Mile Rd
Suite 130
Eastpointe, MI 48021-3349
Mailing address
17200 E 10 Mile Rd
Suite 130
Eastpointe, MI 48021-3349
Phone (586) 585-9047
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3441564 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 1, 2008 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eve Bend D.C. | Past | Accepting new patients |
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.
-
- Chiropractor
- Eastpointe, MI
- NPI 1467851683
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128038400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294963200000",
"number": "1972590420",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17200 E 10 MILE RD",
"address_2": "SUITE 130",
"city": "EASTPOINTE",
"state": "MI",
"postal_code": "480213349",
"telephone_number": "586-585-9047",
"fax_number": "586-585-9126"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17200 E 10 MILE RD",
"address_2": "SUITE 130",
"city": "EASTPOINTE",
"state": "MI",
"postal_code": "480213349",
"telephone_number": "586-585-9047",
"fax_number": "586-585-9126"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTSON",
"first_name": "J",
"middle_name": "ALAN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-30",
"last_updated": "2011-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "MI",
"license": "4301049006",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3441564",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Eastpointe, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2011; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.