Connor James Roberts, MD

Individual provider Active NPI Family Medicine Physician · Howard, WI

NPI 1992201453 · NPPES record last updated Jul 26, 2021

Key facts

NPI
1992201453
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
72544-20 (WI)
Practice address
2793 Lineville Rd
Howard, WI 54313-7152
Phone
(920) 496-4700
NPI assigned
Apr 3, 2018
Sex
Male
Sole proprietor
No

Organizations & group practices 22

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 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Medicare Care Compare profile

Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent Hospital-Hospital Sisters-Third Order of St Francis (593 clinicians)

Practice addresses (Care Compare)

2793 Lineville Rd
Green Bay, WI 54313-7152
Phone (920) 496-4700

Hospital & facility affiliations

  • PRN Home Health and Therapy, LLC Home health agency · Appleton, WI · CCN 527328
  • HSHS Home Care Wisconsin Home health agency · Green Bay, WI · CCN 527132
  • Unity Hospice Hospice · De Pere, WI · CCN 521503
  • Moments Hospice of Green Bay Hospice · Green Bay, WI · CCN 521619
  • St Vincent Hospital Hospital · Green Bay, WI · CCN 520075
  • St Marys Hospital Medical Ctr Hospital · Green Bay, WI · CCN 520097

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100 (apm)
Quality
85.98
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20210804000027 WI Practitioner - Family Practice 7416371265 Reassigns benefits to 3 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
72544-20WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis Current
since Aug 1, 2021
Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis Current
since Aug 1, 2021
Accepting new patients
Prevea Clinic, Inc. Family Medicine Current
since Aug 1, 2021
Accepting new patients
St Nicholas Hospital-Sisters of the Third Order of St Francis Current
since Aug 1, 2021
Accepting new patients
St. Nicholas Hospital-Sisters of the Third Order of St Francis Family Medicine Current Accepting new patients
Prevea Clinic, Inc. Family Medicine Current
since Aug 1, 2021
Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis Family Medicine Current Accepting new patients
St Nicholas Hospital-Sisters of the Third Order of St Francis Current
since Aug 1, 2021
Accepting new patients

Locations

1726 Shawano Ave
Green Bay, WI 54303
Phone (920) 432-6016

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

2793 Lineville Rd
Howard, WI 54313

3100 Superior Ave
Sheboygan, WI 53081
Phone (800) 472-6710

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 72544-20 WI Yes

Addresses

Primary practice location

2793 Lineville Rd
Howard, WI 54313-7152

Mailing address

2731 Main Ave
Kaukauna, WI 54130-3543
Phone (920) 213-6775

Other providers in Howard, WI

All providers in Howard, WI · Family Medicine Physician in Wisconsin

Sources for this page

Verify at the official NPI Registry.