JASON DAVIDSON ROBERTS (FNP) – Nurse Practitioner, NPI 1306199625

JASON DAVIDSON ROBERTS (FNP) is a healthcare provider. based in Springfield, Oregon. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP. They hold a License No. 201507389NP-PP (OR). The NPI Number for JASON DAVIDSON ROBERTS (FNP) is 1306199625

Main info

Male
14 Years Of Experience
Accepts Medicare Assignment
Name
JASON DAVIDSON ROBERTS (FNP)
NPI
1306199625
Phone
(541) 682-3550
Address
2073 OLYMPIC ST
Enumeration Date
24 October 2012
Last Update Date
29 October 2015

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5416823550
Graduation Year
2012 (14 years ago)
PAC ID
9335394857
Group Practice PAC ID
7416853833
Professional Enrollment ID
I20151124001156
Address ID
OR974773413SP2073XSTXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness75
Years active:13State licenses:1Digital endpointsOther names

3,366 NURSE PRACTITIONER in OR

Provider Addresses for JASON DAVIDSON ROBERTS (FNP)

  • 2073 OLYMPIC ST

    SPRINGFIELD, OR 974773413

    Phone: (541) 682-3550

    Fax: (541) 682-3551

    Mailing address matches the actual address.

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: 2015-11-24

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
I20151124001156INurse PractitionerORTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
83036Hemoglobin a1c level5930$0
View full utilization report →

Insurance plans in this area (ZIP 97477)

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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: 7416853833View full group profile

Reviews

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Frequently asked questions

What is JASON DAVIDSON ROBERTS (FNP)'s NPI number?
JASON DAVIDSON ROBERTS (FNP)'s NPI is 1306199625 — the number used across U.S. healthcare to identify this provider.
Active or inactive — what applies to JASON DAVIDSON ROBERTS (FNP)?
You should see JASON DAVIDSON ROBERTS (FNP) as active in CMS-hosted NPPES data.
What kind of doctor is JASON DAVIDSON ROBERTS (FNP)?
JASON DAVIDSON ROBERTS (FNP) is associated with Nurse Practitioner in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with JASON DAVIDSON ROBERTS (FNP)?
Directory geography for JASON DAVIDSON ROBERTS (FNP) centers on Springfield, Oregon.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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