NPIMap

Individual provider Active NPI

Michael Patrick Roberts, M.D.

  • Internal Medicine Physician
  • Niceville, FL
National Provider Identifier
1972691368
Registry record updated Dec 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
TRN9115 Issued in FL
Practice address
1001 College Blvd W Ste D
Niceville, FL 32578-1049
Phone
(850) 389-8333
Fax
(850) 279-6031
NPI assigned
Oct 11, 2006
Last updated
Dec 10, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X TRN9115 FL Primary

Addresses

Primary practice location

1001 College Blvd W Ste D
Niceville, FL 32578-1049

Mailing address

1001 College Blvd W Ste D
Niceville, FL 32578-1049
Phone (850) 389-8333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080918000145 FL Practitioner - Internal MedicinePractitioner - General Practice 2365519253 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: General Practice
Education
Louisiana State University School of Medicine in New Orleans, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Michael P Roberts MD PAGroup PAC ID 8426125311, 4 clinicians
Hospital Medicine Services of FL, LLCGroup PAC ID 9234596743, 513 clinicians
Sports and Orthopedic Rehabilitation Services IncGroup PAC ID 0840104253, shared by 4 NPIs, 314 clinicians

Practice addresses (Care Compare)

151 E Redstone Ave
Crestview, FL 32539-5352
Phone (850) 689-8100

2190 Hwy 85 N
Twin Cities Hospital
Niceville, FL 32578-1045
Phone (850) 729-9468

8429 Tuttle Ave
234 236
Sarasota, FL 34243-2868
Phone (941) 413-1550

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.03 of 100Reported as group
Quality
97.51
Improvement activities
40
Cost
73.43

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TRN9115FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michael P Roberts MD PA Internal Medicine CurrentSince Aug 1, 2008 Accepting new patients
Hospital Medicine Services of FL, LLC CurrentSince Apr 1, 2023 Accepting new patients

Locations

151 E Redstone Ave
Crestview, FL 32539
Phone (850) 629-8515

1700 S 23rd St
Fort Pierce, FL 34950
Phone (772) 461-4000

340 NW Commerce Dr
Lake City, FL 32055
Phone (386) 719-9000

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

1001 College Blvd W
Ste D
Niceville, FL 32578
Phone (850) 389-8333

2190 Highway 85 N
Niceville, FL 32578
Phone (850) 678-4131

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CCEJCA
  • Direct secure messaging: mrober05@yourcarecommunity.org

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 10

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": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575936000000",
    "number": "1972691368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 COLLEGE BLVD W STE D",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325781049",
            "telephone_number": "850-389-8333",
            "fax_number": "850-279-6031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 COLLEGE BLVD W STE D",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325781049",
            "telephone_number": "850-389-8333",
            "fax_number": "850-279-6031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "MICHAEL",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2019-12-10",
        "certification_date": "2019-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "TRN9115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niceville, FL

Sources for this page

Verify at the official NPI Registry.