Philip Leonard Roberts (NPI# 1013012418, PAC ID# 6608777693) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1013012418 |
| PAC ID by PECOS | 6608777693 |
| Professional Enrollment ID | I20040114000625 |
| Full Name | Philip Leonard Roberts |
| Organization Legal Name | MOUNTAINSTAR MEDICAL GROUP-ST. MARKS HOSPITAL LLC |
| Address |
74 E Kimballs Ln Suite 300 Draper UT 84020-5009 |
| Phone Number | 8015720311 |
| Gender | M |
| Credential | MD |
| Medical School | BAYLOR COLLEGE OF MEDICINE |
| Graduation Year | 1976 |
| Primary Specialty | INTERNAL MEDICINE |
| Group Practice PAC ID | 1557443322 |
| Number of Group Practice Members | 21 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 460060 | LONE PEAK HOSPITAL |
| 460010 | INTERMOUNTAIN MEDICAL CENTER |
| 460044 | ALTA VIEW HOSPITAL |
| 460047 | ST MARK'S HOSPITAL |
| 460058 | RIVERTON HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 74 E Kimballs Ln, Suite 300, Draper, UT 84020-5009 | 8015720311 | MOUNTAINSTAR MEDICAL GROUP-ST. MARKS HOSPITAL LLC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PHCDRR_1 | Immunization Registry Reporting | % | |
| ACI_EC_TRANS_PHCDRR_3 | Specialized Registry Reporting | % | |
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % |
| Organization Legal Name | MOUNTAINSTAR MEDICAL GROUP-ST. MARKS HOSPITAL LLC |
| Physicians | 21 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Todd W. Furness | Family Medicine | Mountainstar Medical Group-st. Marks Hospital LLC | 11760 S 700 E, Suite 111, Draper, UT 84020-6605 |
| Todd N Schauers | Physician Assistant | Mountainstar Medical Group-st. Marks Hospital LLC | 4465 S 900 E, Suite 200, Salt Lake City, UT 84124-2456 |
| Daniel Trevor Young | Family Medicine | Mountainstar Medical Group-st. Marks Hospital LLC | 74 E Kimballs Ln, Suite 300, Draper, UT 84020-5009 |
| David B Jack | Family Medicine | Mountainstar Medical Group-st. Marks Hospital LLC | 74 E Kimballs Ln, Draper, UT 84020-5009 |
| Amelia Maass | Nurse Practitioner | Mountainstar Medical Group-st. Marks Hospital LLC | 4465 S 900 E, Suite 200, Salt Lake City, UT 84124-2456 |
| Andrew Robinson | Family Medicine | Mountainstar Medical Group-st. Marks Hospital LLC | 74 E Kimballs Ln, Draper, UT 84020-5009 |
| Matthew M Schellenberg | Family Medicine | Mountainstar Medical Group-st. Marks Hospital LLC | 74 E Kimballs Ln, Draper, UT 84020-5009 |
| Richard Wayne Bennett | Internal Medicine | Mountainstar Medical Group-st. Marks Hospital LLC | 74 E Kimballs Ln, Draper, UT 84020-5009 |
| Joni W Hougaard | Family Medicine | Mountainstar Medical Group-st. Marks Hospital LLC | 4465 S 900 E, Suite 200, Salt Lake City, UT 84124-2456 |
| Evan Reinhardt | Family Medicine | Mountainstar Medical Group-st. Marks Hospital LLC | 8846 S Redwood Rd, 121 Jordan Family Health, West Jordan, UT 84088-9334 |
| Street Address |
74 E KIMBALLS LN SUITE 300 |
| City | DRAPER |
| State | UT |
| Zip | 84020-5009 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| James S Zebrack | Cardiovascular Disease (cardiology) | Mountainstar Cardiology St Marks LLC | 74 E Kimballs Ln, Suite 260, Draper, UT 84020-5009 |
| Scott E Bruderer | Physician Assistant | Mountainstar Specialty Services LLC | 74 E Kimballs Ln, Suite 330, Draper, UT 84020-5006 |
| Kenneth G Nielson | Cardiovascular Disease (cardiology) | Mountainstar Cardiology St Marks LLC | 74 E Kimballs Ln, Suite 260, Draper, UT 84020-5009 |
| Larry E Urry | Dermatology | 74 E Kimballs Ln, Suite 230, Draper, UT 84020-5005 | |
| Daniel Trevor Young | Family Medicine | Mountainstar Medical Group-st. Marks Hospital LLC | 74 E Kimballs Ln, Suite 300, Draper, UT 84020-5009 |
| Traske M Muir | Orthopedic Surgery | Mountainstar Specialty Services LLC | 74 E Kimballs Ln, Suite 330, Draper, UT 84020-5006 |
| David B Jack | Family Medicine | Mountainstar Medical Group-st. Marks Hospital LLC | 74 E Kimballs Ln, Draper, UT 84020-5009 |
| Vamsee M Yaganti | Interventional Cardiology | Mountainstar Cardiology St Marks LLC | 74 E Kimballs Ln, Suite 260, Draper, UT 84020-5009 |
| Andrew Charles Behunin | Internal Medicine | Mountainstar Cardiology St Marks LLC | 74 E Kimballs Ln, Suite 260, Draper, UT 84020-5009 |
| Andrew Robinson | Family Medicine | Mountainstar Medical Group-st. Marks Hospital LLC | 74 E Kimballs Ln, Draper, UT 84020-5009 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mark Christensen | Emergency Medicine | Emergency Physicians Integrated Care LLC | 11800 S State St, Lone Peak Emergency Center, Draper, UT 84020-0001 |
| Matthew Broadwater-hollifield | Emergency Medicine | Emergency Physicians Integrated Care LLC | 11800 S State St, Lone Peak Emergency Center, Draper, UT 84020-0001 |
| Azher M Merchant | Emergency Medicine | Emergency Physicians Integrated Care LLC | 11800 S State St, Lone Peak Emergency Center, Draper, UT 84020-0001 |
| Jeffrey L Hardin | Emergency Medicine | Emergency Physicians Integrated Care LLC | 11800 S State St, Lone Peak Emergency Center, Draper, UT 84020-0001 |
| Laurie C Raborn | Emergency Medicine | Emergency Physicians Integrated Care LLC | 11800 S State St, Lone Peak Emergency Center, Draper, UT 84020-0001 |
| Jinghui Li | Emergency Medicine | Emergency Physicians Integrated Care LLC | 11800 S State St, Lone Peak Emergency Center, Draper, UT 84020-0001 |
| Charles David Eller | Emergency Medicine | Emergency Physicians Integrated Care LLC | 11800 S State St, Lone Peak Emergency Center, Draper, UT 84020-0001 |
| Jeremy Voros | Emergency Medicine | Emergency Physicians Integrated Care LLC | 11800 S State St, Lone Peak Emergency Center, Draper, UT 84020-0001 |
| Jennifer F Robison | Psychologist, Clinical | 12481 S Fort St, Suite 275, Draper, UT 84020-2106 | |
| Matthew D Smith | Chiropractic | Elite Performance Health Center PC | 13552 S 110 W, Suite 204, Draper, UT 84020-2403 |
| Find all physicians in zip 84020 | |||
| City | DRAPER |
| Zip Code | 84020 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | DRAPER + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Philip Leonard Roberts.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.