JOHN W. ROBERTSON (M.D.) – Surgery Physician, NPI 1285692673

JOHN W. ROBERTSON (M.D.) is a healthcare provider. based in Lake mary, Florida. specializing in Surgery Physician. They hold the professional credentials M.D.. They hold a License No. ME37713 (FL). The NPI Number for JOHN W. ROBERTSON (M.D.) is 1285692673

Main info

Male
47 Years Of Experience
Accepts Medicare Assignment
Name
JOHN W. ROBERTSON (M.D.)
NPI
1285692673
Phone
(407) 833-9195
Address
4106 W LAKE MARY BLVD
Enumeration Date
3 May 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
UNIVERSITY OF FLORIDA COLLEGE OF MEDICINE
Secondary Phone
4073035214
Graduation Year
1979 (47 years ago)
PAC ID
7315024973
Group Practice PAC ID
0749186153
Professional Enrollment ID
I20100323000852
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for JOHN W. ROBERTSON (M.D.)

  • 4106, West Lake Mary Boulevard, Lake Mary, Seminole County, Florida, 32746, United States

    SUITE 330

    LAKE MARY, FL 327463315

    Phone: (407) 833-9195

    Fax: (407) 833-9308

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-03-23

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20100323000852IGeneral SurgeryFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32746)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0749186153View full group profile
NameSpecialtyState
Physician AssistantFL
N E U R O L O G YFL
General SurgeryFL
Cardiovascular Disease (Cardiology), Internal Medicine, Interventional CardiologyFL
Nurse PractitionerFL
O B S T E T R I C S/ G Y N E C O L O G YFL
General SurgeryFL
Pulmonary Disease, Critical Care (Intensivists)FL
O B S T E T R I C S/ G Y N E C O L O G YMI
Physician AssistantFL

Reviews

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Frequently asked questions

Does JOHN W. ROBERTSON (M.D.) have a public NPI I can cite?
Public records show JOHN W. ROBERTSON (M.D.) under NPI 1285692673.
Does the public listing show JOHN W. ROBERTSON (M.D.) as active?
JOHN W. ROBERTSON (M.D.)'s NPI record reflects an active status in NPPES.
Which specialty label fits JOHN W. ROBERTSON (M.D.)?
NPPES ties JOHN W. ROBERTSON (M.D.) to Surgery Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
What geographic area is tied to JOHN W. ROBERTSON (M.D.)?
JOHN W. ROBERTSON (M.D.) is associated with Lake Mary, Florida in the same public data insurers reference.
Can I export JOHN W. ROBERTSON (M.D.)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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