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DONNA J ROBERTS MD
NPI 1255348710
Family Medicine in Bluffton, SC

Active since August 01, 2006PECOS EnrolledAccepts Medicare Assignment
76.84/100
CMS Quality Rating
1 BURNT CHURCH RD, BLUFFTON, SC 29910(843) 985-1950 Get Directions Write a Review

NPPES record last updated: August 29, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 29, 2022, Mar 17, 2018, Feb 28, 2017 (3 updates tracked since 2017).

About Donna J Roberts Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DONNA J ROBERTS MD (NPI 1255348710) is an individual family medicine provider in Bluffton, South Carolina, licensed in Georgia (37349) and active in the NPI registry since August 2006. She is enrolled in Medicare PECOS and is a graduate of Medical College Of Georgia School Of Medicine (1991).

NPPES Registry Identity

NPI1255348710
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameDONNA J ROBERTSCredential: MD
Location Address1 BURNT CHURCH RDBluffton, SC 29910-6405
Mailing AddressPo Box 935722Atlanta, GA 31193-5722 · (843) 792-6200
Phone(843) 985-1950
Sole ProprietorNo
Medical School CMSMedical College Of Georgia School Of MedicineGraduated 1991
Enumeration DateAugust 1, 2006
Last NPPES UpdateAugust 29, 20223 updates tracked since enumeration
NPPES CertifiedAugust 29, 2022
✔ NPI 1255348710 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses✔ Licensed in GA · 37349✔ Licensed in SC · 40504
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1 BURNT CHURCH RD, Bluffton, SC 29910
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include First Choice Next.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Donna J Roberts Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8820012867
PECOS Enrollment IDI20200204000204
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 9

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
481 services334 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
281 services228 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
151 services151 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
102 services81 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
87 services83 patients
Automated urinalysis test 81003
An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.
23 services22 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29910 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.18 typical visit price
range $53.57 – $163.84
Typical copayment $20.79 (range $13.39 – $40.96)
Most-billed visit code 99203
Established Patient
$95.12 typical visit price
range $16.96 – $133.52
Typical copayment $23.78 (range $4.24 – $33.38)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

76.84/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality71.08
Promoting Interoperability99
Improvement Activities40
Cost52.57

Reported Quality Measures

Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
84%105 patients4/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
82%142 patients4/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
93%150 patients4/55-star benchmark: 100%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
82%145 patients4/55-star benchmark: 100%
Screening for Osteoporosis for Women Aged 65-85 Years of Age
Percentage of female patients aged 65-85 years of age who ever had a central dual-energy X-ray absorptiometry (DXA) to check for osteoporosis
97%64 patients4/55-star benchmark: 98%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
8 suppliers21 claims60 services$5.62 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
4 suppliers29 claims29 services$196.09 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. CHRISTOPHER M OPELLA M.D.
Family Medicine
1 BURNT CHURCH RD
BLUFFTON, SC 29910
Beaufort County (817) 270-0788
BURNT CHURCH PRIMARY AND URGENT CARE, LLC
Family Medicine (Adolescent Medicine)
1 BURNT CHURCH RD
BLUFFTON, SC 29910
Beaufort County (843) 757-9229
MRS. AMY MORRISSETTE
Nurse Practitioner (Family)
1 BURNT CHURCH RD
BLUFFTON, SC 29910
Beaufort County (843) 706-2185
BURNT CHURCH PRIMARY AND URGENT CARE, LLC
Emergency Medicine
1 BURNT CHURCH RD
BLUFFTON, SC 29910
Beaufort County (843) 757-9229

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 Donna Roberts's NPI number?

The NPI number for Donna Roberts is 1255348710. It was assigned to this individual provider in the NPPES registry on August 1, 2006.

Where is Donna Roberts located?

Donna Roberts practices at 1 Burnt Church Rd, Bluffton, SC 29910. The listed phone number is (843) 985-1950.

What is Donna Roberts's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Donna Roberts enrolled in Medicare?

Yes. Donna Roberts is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Donna Roberts accept?

Health plans from First Choice Next list Donna 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.

When was this NPI record last updated?

The NPPES record for Donna Roberts was last updated on August 29, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.