MOLLY ROBERSON (PA) – Surgical Physician Assistant, NPI 1194224048

MOLLY ROBERSON (PA) is a healthcare provider. based in Louisville, Kentucky. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. The NPI Number for MOLLY ROBERSON (PA) is 1194224048

Main info

Female
9 Years Of Experience
Accepts Medicare Assignment
Name
MOLLY ROBERSON (PA)
NPI
1194224048
Phone
(502) 394-6341
Address
9880 ANGIES WAY STE 250
Enumeration Date
6 February 2018
Last Update Date
25 July 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5029090772
Graduation Year
2017 (9 years ago)
PAC ID
7810258720
Group Practice PAC ID
0547595316
Professional Enrollment ID
I20181213000755
Address ID
KY402074605LO4000XWAYX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience21
Completeness75
Years active:8State licenses:0Digital endpointsOther names

1,728 PHYSICIAN ASSISTANT in KY

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Provider Addresses for MOLLY ROBERSON (PA)

  • Angies Way, Old Brownsboro Crossing, Worthington, Louisville, Jefferson County, Kentucky, 40241-8103, United States

    LOUISVILLE, KY 402412865

    Phone: (502) 394-6341

    Fax: (502) 394-6340

    Type: Location

  • 1064 Eastern Pkwy

    Louisville, KY 402171532

    Phone: (502) 489-4325

    Type: Location

  • Northgate Court, New Albany, Floyd County, Indiana, 47150, United States

    NEW ALBANY, IN 471506422

    Phone: (812) 207-2130

    Fax: (812) 207-2140

    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: 2018-12-13

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
I20181213000755IPhysician AssistantKYTBD

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 40241)

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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: 0547595316View full group profile
NameSpecialtyState
Clinical PsychologistKY
Clinical PsychologistOH
Nurse PractitionerKY
Physician AssistantKY
Physical Therapist In Private PracticeKY
Physical Therapist In Private PracticeTN
Orthopedic SurgeryKY
Clinical PsychologistKY
Physician AssistantKY
Pain Management, Physical Medicine And RehabilitationKY

Reviews

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Frequently asked questions

What federal number belongs to MOLLY ROBERSON (PA)?
The federal identifier for MOLLY ROBERSON (PA) is NPI 1194224048.
Is MOLLY ROBERSON (PA) active in the national directory?
MOLLY ROBERSON (PA)'s public NPI profile is in an active state.
Does MOLLY ROBERSON (PA) list a primary specialty?
If you are matching referrals, note Surgical Physician Assistant for MOLLY ROBERSON (PA). Clinical services aligned with this taxonomy classification.
What location shows for MOLLY ROBERSON (PA)?
We surface Louisville, Kentucky for MOLLY ROBERSON (PA) based on available NPPES addresses.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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