Ally Roberts, RD is a medicare enrolled "Dietitian, Registered" provider in Cumberland, Wisconsin. Her current practice location is
1110 7th Ave, Cumberland, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(715) 822-7200.
Ally Roberts is licensed to practice in Wisconsin (license number 3510-29) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1538832605.
Healthcare Provider's Profile
| Full Name | Ally Roberts |
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| Gender | Female |
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| Speciality | Dietitian, Registered |
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| Location | 1110 7th Ave, Cumberland, Wisconsin |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1538832605
- Provider Enumeration Date: 07/26/2021
- Last Update Date: 07/26/2021
Medicare PECOS Information:
- PECOS PAC ID: 6305240441
- Enrollment ID: I20230105001736
Medical Identifiers
Medical identifiers for Ally Roberts such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1538832605 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 133V00000X | Dietitian, Registered | 3510-29 (Wisconsin) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ally Roberts allows following entities to bill medicare on her behalf.
| Provider Name | St Lukes Hospital Of Duluth |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1902845068
PECOS PAC ID: 7113834839
Enrollment ID: O20031120000212 |
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| Provider Name | Sawtooth Mountain Clinic Inc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1306832894
PECOS PAC ID: 8224940010
Enrollment ID: O20041103000490 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ally Roberts is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Ally Roberts, RD
1110 7th Ave,
Cumberland, WI 54829-9138
Ph: (715) 822-7200 | Ally Roberts, RD
1110 7th Ave,
Cumberland, WI 54829-9138
Ph: (715) 822-7200 |
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