DOMINICA N ROBERTS FNP
NPI 1124594080
Nurse Practitioner - Family in North Bend, OR
About Dominica N Roberts Fnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DOMINICA N ROBERTS FNP (NPI 1124594080) is an individual family provider in North Bend, Oregon, licensed in Oregon (10042861) and active in the NPI registry since October 2018. She is enrolled in Medicare PECOS, is affiliated with Bay Area Hospital, and is a graduate of Other (2024).
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dominica N Roberts Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show Dominica Roberts reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
North Bend, OR 97459
- Reassigned Medicare billing, Oregon enrollment
- 35 clinicians in this Medicare group
Ukiah, CA 95482
- Reassigned Medicare billing, California enrollment
- 121 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Bay Area Hospital
Acute Care Hospitals · Coos Bay, ORPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 97459 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 16
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Dominica Roberts's NPI number?
The NPI number for Dominica Roberts is 1124594080. It was assigned to this individual provider in the NPPES registry on October 18, 2018.
Where is Dominica Roberts located?
Dominica Roberts practices at 1890 Waite St, North Bend, OR 97459. The listed phone number is (541) 756-6232.
What is Dominica Roberts's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Dominica Roberts enrolled in Medicare?
Yes. Dominica Roberts is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Dominica Roberts's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Dominica Roberts reassigns Medicare benefits to 2 organizations: Waterfall Clinic Incorporated (North Bend, OR) and Mendocino Community Health Clinic, Inc. (Ukiah, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Dominica Roberts's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Dominica Roberts accept?
Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans and Regence BlueCross BlueShield of Oregon list Dominica Roberts as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is Dominica Roberts affiliated with any hospitals?
According to CMS data, Dominica Roberts is affiliated with Bay Area Hospital.
When was this NPI record last updated?
The NPPES record for Dominica Roberts was last updated on March 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dominica N Roberts, FNP · NPI 1124594080
Family physician in North Bend, Oregon. Individual provider, active in the CMS NPPES registry since October 18, 2018.
## Identity
- **NPI:** 1124594080 (Entity type: Individual)
- **Enumerated:** October 18, 2018
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 10042861 (Oregon)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1890 WAITE ST, North Bend, OR 97459-1229
- **Phone:** (541) 756-6232
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Waterfall Clinic Incorporated (NPI 1619915113, North Bend, OR); Mendocino Community Health Clinic, Inc. (NPI 1750809463, Ukiah, CA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2024
## Record status
- **NPPES last updated:** March 27, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1124594080) · Data from the CMS NPPES public registry.