DR. BRADLEY WANE ROBERTS D.M.D.
NPI 1497074025
Dentist - Oral and Maxillofacial Surgery in Alton, IL

Q: What is Bradley Roberts's NPI number?

The NPI number for Bradley Roberts is 1497074025. It was assigned to this individual provider in the NPPES registry on May 21, 2010.

Q: What is Bradley Roberts's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Q: Is Bradley Roberts enrolled in Medicare?

No. Bradley Roberts has opted out of Medicare through February 26, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Bradley Roberts was last updated on May 21, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.

Active since May 21, 2010Opted out of Medicare · through Feb 26, 2027

4 PROFESSIONAL DR, ALTON, IL 62002(618) 465-9000 Get Directions Write a Review

NPPES record last updated: May 21, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Bradley Wane Roberts D.m.d. NPPES

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

DR. BRADLEY WANE ROBERTS D.M.D. (NPI 1497074025) is an individual oral and maxillofacial surgery provider in Alton, Illinois, licensed in Illinois (019019769) and active in the NPI registry since May 2010. He has opted out of Medicare through February 26, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1497074025

Entity TypeIndividualMale

Primary Taxonomy1223S0112X

Provider Legal NameDR. BRADLEY WANE ROBERTSCredential: D.M.D.

Location Address4 PROFESSIONAL DRAlton, IL 62002-5067

Mailing Address4 Professional DrAlton, IL 62002-5067 · (618) 465-9000

Phone(618) 465-9000

Sole ProprietorYes

Enumeration DateMay 21, 2010

✔ NPI 1497074025 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers

Taxonomy Code1223S0112X

License✔ Licensed in IL · 019019769

Definition

An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

4 PROFESSIONAL DR, Alton, IL 62002

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Other Identifiers 1

Medicare PIN757170IL

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Bradley Wane Roberts D.m.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from February 26, 2013 through February 26, 2027.

Opt-Out Effective DateFebruary 26, 2013

Opt-Out In Effect ThroughFebruary 26, 2027Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62002 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

$88.44 typical visit price

range $56.28 – $173.35

Typical copayment $22.11 (range $14.07 – $43.33)

Most-billed visit code 99203

Established Patient

$70.42 typical visit price

range $17.51 – $139.99

Typical copayment $17.60 (range $4.37 – $34.99)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Bradley Roberts's NPI number?

The NPI number for Bradley Roberts is 1497074025. It was assigned to this individual provider in the NPPES registry on May 21, 2010.

Where is Bradley Roberts located?

Bradley Roberts practices at 4 Professional Dr, Alton, IL 62002. The listed phone number is (618) 465-9000.

What is Bradley Roberts's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Bradley Roberts enrolled in Medicare?

No. Bradley Roberts has opted out of Medicare through February 26, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Bradley Roberts was last updated on May 21, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.