TOM BUI ROBERTS (PA) – Physician Assistant, NPI 1104480177

TOM BUI ROBERTS (PA) is a healthcare provider. based in Olathe, Kansas. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. The NPI Number for TOM BUI ROBERTS (PA) is 1104480177

Main info

Male
7 Years Of Experience
Accepts Medicare Assignment
Name
TOM BUI ROBERTS (PA)
NPI
1104480177
Phone
(913) 522-3128
Address
12500 W 148th St
Enumeration Date
25 April 2019
Last Update Date
17 March 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7329556765
Graduation Year
2019 (7 years ago)
PAC ID
8325376395
Group Practice PAC ID
6406808708
Professional Enrollment ID
I20190829000611
Address ID
NJ088163721EA641XX18XX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:7State licenses:0Digital endpointsOther names

1,303 PHYSICIAN ASSISTANT in KS

Provider Addresses for TOM BUI ROBERTS (PA)

  • 12500 W 148th St

    Olathe, KS 660629454

    Phone: (913) 522-3128

    Type: Location

  • 10 Forest Ave Ste 100

    Paramus, NJ 07652

    Phone: (210) 996-1505

    Type: Location

  • Forest Avenue, Paramus, Bergen County, New Jersey, 07652, United States

    PARAMUS, NJ 07652

    Phone: (210) 996-1505

    Type: Location

  • 273 16TH ST APT 1211

    JERSEY CITY, NJ 073101069

    Phone: (913) 522-3128

    Type: Mailing

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: 2019-08-29

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
I20190829000611IPhysician AssistantNJTBD

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 66062)

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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: 6406808708View full group profile
NameSpecialtyState
Emergency MedicineNJ
Nurse PractitionerNJ
Emergency MedicineNJ
Emergency MedicineNJ
Physician AssistantNJ
Physician AssistantNJ
Nurse PractitionerNJ
Nurse PractitionerPA

Reviews

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Frequently asked questions

What identifier follows TOM BUI ROBERTS (PA) across health systems?
The NPI 1104480177 uniquely identifies TOM BUI ROBERTS (PA) in U.S. healthcare data.
Is TOM BUI ROBERTS (PA) currently accepting referrals based on NPI status?
Registry metadata lists TOM BUI ROBERTS (PA) as active.
What does the directory say TOM BUI ROBERTS (PA) does?
Insurance directories may phrase it differently, but here TOM BUI ROBERTS (PA) maps to Physician Assistant. Clinical services aligned with this taxonomy classification.
Can patients visit TOM BUI ROBERTS (PA) in Olathe, Kansas?
For routing, start with Olathe, Kansas for TOM BUI ROBERTS (PA), then verify phone and hours locally.
Who maintains TOM BUI ROBERTS (PA)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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