MS. MARY JACQUELINE ROBERTS (APRN, FNP) – Family Nurse Practitioner, NPI 1609150598
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MS. MARY JACQUELINE ROBERTS (APRN, FNP)
1331 Christy Ave
#1
Louisville, KY 402042038
Phone: (502) 583-3293
Type: Location
1331 CHRISTY AVE
#1
LOUISVILLE, KY 402042038
Phone: (502) 583-3293
Type: Mailing
PO BOX 776351
CHICAGO, IL 606776351
Phone: (502) 588-9408
Fax: (502) 272-5116
Type: Mailing
1465 N GARDNER ST
SCOTTSBURG, IN 471707751
Phone: (812) 752-0001
Fax: (812) 752-0010
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $32.
Total Amount is formed as General ($32) + Research ($0) + Ownership ($0) = $32.
Last reported payment date: 2024-10-23 • Largest payer in this snapshot: ABBVIE INC. ($17).
Total Amount
$32
General + Research + Ownership
Payments
2
Total payment records
General Amount
$32
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-23
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $17 |
| AstraZeneca Pharmaceuticals LP | $15 |
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: 2014-03-18
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20140318001013 | I | Nurse Practitioner | IN | TBD |
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.
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 40204)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | IN | |
| - | IN | |
| Nurse Practitioner | TN | |
| Nurse Practitioner | IN | |
| Nurse Practitioner | IN | |
| Nurse Practitioner | IN | |
| - | KY | |
| Nurse Practitioner | IN | |
| Nurse Practitioner | IN | |
| Nurse Practitioner | IN |
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