DR. JAMES WALLACE ROBERTSON (MD) – Pediatrics Physician, NPI 1457357832
Pediatrics Physician
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
1,204 PEDIATRIC MEDICINE in MI
Provider Addresses for DR. JAMES WALLACE ROBERTSON (MD)
1250 E Michigan Ave
Grayling, MI 497387074
Phone: (989) 348-0550
Type: Location
Kids Creek, 5024, North Royal Drive, Garfield Township, Grand Traverse County, Michigan, 49684, United States
TRAVERSE CITY, MI 496849230
Phone: (231) 935-0555
Type: Mailing
14719 W Upright St
Charlevoix, MI 497201949
Phone: (231) 547-3840
Type: Location
829 N Center Ave Ste 130
Gaylord, MI 497351684
Phone: (989) 731-7930
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $14.
Total Amount is formed as General ($14) + Research ($0) + Ownership ($0) = $14.
Last reported payment date: 2024-10-04 • Largest payer in this snapshot: Supernus Pharmaceuticals, Inc. ($14).
Total Amount
$14
General + Research + Ownership
Payments
1
Total payment records
General Amount
$14
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-04
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Supernus Pharmaceuticals, Inc. | $14 |
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: 2011-01-25
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 |
|---|---|---|---|---|
| I20110125000889 | I | Pediatric Medicine | MI | 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 49738)
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