DOMINICA N ROBERTS (FNP) – Registered Nurse, NPI 1124594080
Registered Nurse
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,366 NURSE PRACTITIONER in OR
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Provider Addresses for DOMINICA N ROBERTS (FNP)
610, Dragon Drive, Monroe, Benton County, Oregon, 97456, United States
MONROE, OR 974569604
Phone: (541) 766-6000
Fax: (541) 766-6047
Type: Mailing
333 LAWS AVE
UKIAH, CA 954826540
Phone: (707) 468-1010
Type: Mailing
3810 BUCCANEER LN APT D
NORTH BEND, OR 974592490
Phone: (541) 756-6232
Type: Mailing
1890 WAITE ST
NORTH BEND, OR 974591229
Phone: (541) 756-6232
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: 2025-02-14
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 |
|---|---|---|---|---|
| I20250214002677 | I | Nurse Practitioner | CA | 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 97456)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | CA | |
| Nurse Practitioner | CA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MT | |
| - | CA | |
| - | CA | |
| - | CA | |
| Nurse Practitioner | CA | |
| Nurse Practitioner | CA | |
| - | CA | |
| Clinical Social Worker | CA |
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