DR. JOHN D ROBERTS (O.D.) – Optometrist, NPI 1730186131

DR. JOHN D ROBERTS (O.D.) is a healthcare provider. based in Summerfield, Florida. specializing in Optometrist. They hold the professional credentials O.D.. They hold a License No. 1048DT (KY). The NPI Number for DR. JOHN D ROBERTS (O.D.) is 1730186131

Main info

Male
42 Years Of Experience
Accepts Medicare Assignment
Name
DR. JOHN D ROBERTS (O.D.)
NPI
1730186131
Phone
(270) 319-1115
Address
17430 SE 115TH TERRACE RD
Enumeration Date
30 June 2005
Last Update Date
20 June 2014

Doctor Profile

Medical School Name
SOUTHERN COLLEGE OF OPTOMETRY
Secondary Phone
2707652020
Graduation Year
1984 (42 years ago)
PAC ID
1153335575
Group Practice PAC ID
0749504165
Professional Enrollment ID
I20060206000364
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

Provider Addresses for DR. JOHN D ROBERTS (O.D.)

  • 17430 SE 115TH TERRACE RD

    SUMMERFIELD, FL 344917825

    Phone: (270) 319-1115

    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: 2006-02-06

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
I20060206000364IOptometryKYTBD

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 34491)

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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: 0749504165View full group profile

Reviews

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Frequently asked questions

What identifier follows DR. JOHN D ROBERTS (O.D.) across health systems?
The NPI 1730186131 uniquely identifies DR. JOHN D ROBERTS (O.D.) in U.S. healthcare data.
Quick check: is DR. JOHN D ROBERTS (O.D.) active?
Public NPPES data shows DR. JOHN D ROBERTS (O.D.) with an active NPI status right now.
What does the directory say DR. JOHN D ROBERTS (O.D.) does?
Insurance directories may phrase it differently, but here DR. JOHN D ROBERTS (O.D.) maps to Optometrist. Clinical services aligned with this taxonomy classification.
Is DR. JOHN D ROBERTS (O.D.) tied to Summerfield, Florida?
If you are local to Summerfield, Florida, DR. JOHN D ROBERTS (O.D.) may be relevant to your search.
Can I export DR. JOHN D ROBERTS (O.D.)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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