Individual provider Active NPI

Michael D. Roebuck, M.D.

  • Emergency Medical Services (Emergency Medicine) Physician
  • Flint, MI
National Provider Identifier
1992894406
Registry record updated Feb 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
4301064317 Issued in MI
Practice address
1 Hurley PLZ
Flint, MI 48503-5902
Phone
(810) 257-9429
Fax
(810) 257-9104
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 4301064317 MI Primary

Addresses

Primary practice location

1 Hurley PLZ
Flint, MI 48503-5902

Mailing address

1 Hurley PLZ
Flint, MI 48503-5902
Phone (810) 262-9002

Other identifiers 2

IdentifierTypeStateIssuer
3427510MedicaidMI
0B51090OtherMIBLUE SHIELD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mroebuck4040@direct.hurleymc.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20100604000074 MI Practitioner - Emergency Medicine 1759410533 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
92.4 of 100Reported as group
Quality
66.97
Promoting interoperability
100
Improvement activities
40
Cost
75.88

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301064317MIMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hurley Medical Center Current Accepting new patients
Hurley Medical Center CurrentSince Jan 1, 1998 Accepting new patients
Hurley Medical Center Current Accepting new patients
Hurley Medical Center CurrentSince Jan 1, 1998 Accepting new patients
Pathology Associates Inc PC Current Accepting new patients

Locations

1 Hurley Plz
Fl 5
Flint, MI 48503
Phone (810) 262-9353

1 Hurley Plz
Flint, MI 48503
Phone (810) 257-9000

Organizations & group practices 5

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675987200000",
    "number": "1992894406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HURLEY PLZ",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485035902",
            "telephone_number": "810-262-9002",
            "fax_number": "810-262-9483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HURLEY PLZ",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485035902",
            "telephone_number": "810-257-9429",
            "fax_number": "810-257-9104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROEBUCK",
        "first_name": "MICHAEL",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2023-02-10",
        "certification_date": "2023-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "MI",
            "license": "4301064317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3427510",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "0B51090",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mroebuck4040@direct.hurleymc.com",
            "affiliation": "N",
            "address_1": "1 Hurley Plz",
            "city": "Flint",
            "state": "MI",
            "country_code": "US",
            "postal_code": "485035902",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.