DR. JEAN A. ROBERTS (PHD) – Psychologist, NPI 1053504027

DR. JEAN A. ROBERTS (PHD) is a healthcare provider. based in Toledo, Ohio. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PHD. They hold a License No. E0007114-S (OH). The NPI Number for DR. JEAN A. ROBERTS (PHD) is 1053504027

Main info

Female
Sole Proprietor
20 Years Of Experience
Name
DR. JEAN A. ROBERTS (PHD)
NPI
1053504027
Phone
(419) 517-1758
Address
PO BOX 8970
Enumeration Date
23 August 2007
Last Update Date
12 October 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4193188533
Graduation Year
2006 (20 years ago)
PAC ID
0446552830
Group Practice PAC ID
1254736853
Professional Enrollment ID
I20151230002800
Address ID
OH436061356TO3454XCTXX404
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience59
Completeness75
Years active:18State licenses:2Digital endpointsOther names

1,139 CLINICAL PSYCHOLOGIST in OH

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Provider Addresses for DR. JEAN A. ROBERTS (PHD)

  • PO BOX 8970

    TOLEDO, OH 436230970

    Phone: (419) 517-1758

    Fax: (419) 517-1399

    Type: Mailing

  • 2109, Hughes Drive, Toledo, Lucas County, Ohio, 43606, United States

    JOBST TOWER #640

    TOLEDO, OH 436063856

    Phone: (567) 661-0505

    Fax: (419) 291-6436

    Type: Location

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: 2015-12-30

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
I20151230002800IClinical PsychologistOHTBD

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 43623)

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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: 1254736853View full group profile
NameSpecialtyState
Clinical Social WorkerOH
Mental Health CounselorOH
Mental Health CounselorOH
Mental Health CounselorOH
Mental Health CounselorOH
Clinical Social WorkerOH
Clinical Social WorkerOH
Mental Health CounselorOH

Reviews

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Frequently asked questions

What is the standard ID for DR. JEAN A. ROBERTS (PHD) in the U.S.?
In the U.S., DR. JEAN A. ROBERTS (PHD) is identified by NPI 1053504027.
Should I treat DR. JEAN A. ROBERTS (PHD) as an active provider?
Patients and plans typically see DR. JEAN A. ROBERTS (PHD) as active in the national extract.
Which specialty label fits DR. JEAN A. ROBERTS (PHD)?
NPPES ties DR. JEAN A. ROBERTS (PHD) to Psychologist in the taxonomy section. Clinical services aligned with this taxonomy classification.
Is DR. JEAN A. ROBERTS (PHD) tied to Toledo, Ohio?
If you are local to Toledo, Ohio, DR. JEAN A. ROBERTS (PHD) may be relevant to your search.
Who maintains DR. JEAN A. ROBERTS (PHD)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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