Provider Demographics
NPI:1316125982
Name:ROBERTS, CARLOS A (MD)
Entity type:Individual
Prefix:
First Name:CARLOS
Middle Name:A
Last Name:ROBERTS
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 MEMORY LN
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2231
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:
Practice Address - Street 1:35 MONUMENT RD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-5074
Practice Address - Country:US
Practice Address - Phone:717-851-2443
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-06
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD432832207VF0040X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyUrogynecology and Reconstructive Pelvic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA20086880OtherAMERIHEALTH MERCY YHOBT
PA30146680OtherAMERIHEALTH CARITAS PENNSYLVANIA - WMG
PA50077473OtherCAPITAL BLUE CROSS-WMG
PA50083660OtherCAPITAL BLUE CROSS YHOBT
PA9939181OtherAETNA
PA102113614Medicaid
PA118474OtherGEISINGER HEALTH PLAN
MD929853OtherCAREFIRST MD BCBS
PA1572030OtherGATEWAY-WMG
PA212425OtherJOHNS HOPKINS
PA2027807OtherHIGHMARK BLUE SHIELD
PA20076136OtherAMERIHEALTH MERCY-WMG
MD929853OtherCAREFIRST MD BCBS
PA126767EZ3Medicare PIN
PA1572030OtherGATEWAY-WMG