Individual provider Active NPI

Giorgio Roveran, M.D.

  • Internal Medicine Physician
  • Redlands, CA
National Provider Identifier
1013155175
Registry record updated Jan 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A106675 Issued in CA
Practice address
26001 Redlands Blvd
Redlands, CA 92373-7762
Phone
(909) 825-7084
Fax
(909) 894-7961
NPI assigned
Jan 28, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A106675 CA Primary

Addresses

Primary practice location

26001 Redlands Blvd
Redlands, CA 92373-7762

Mailing address

2045 Compton Ave Ste 101
Corona, CA 92881-7286
Phone (951) 817-8820

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170213000540 CA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 2163558073

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
106675CAMDGeneral Practice Dentistry
A106675CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Talbert Medical Group, P.C. Internal Medicine Past Accepting new patients
Providence Facey Medical Foundation Past Accepting new patients
Providence Facey Medical Foundation Internal Medicine Past Accepting new patients
Felice L. Gersh, M.D., Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: groveran53898@direct.llu.edu

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1233100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672963200000",
    "number": "1013155175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2045 COMPTON AVE STE 101",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928817286",
            "telephone_number": "951-817-8820",
            "fax_number": "951-817-8856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26001 REDLANDS BLVD",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923737762",
            "telephone_number": "909-825-7084",
            "fax_number": "909-894-7961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROVERAN",
        "first_name": "GIORGIO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-28",
        "last_updated": "2023-01-06",
        "certification_date": "2023-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A106675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

Verify at the official NPI Registry.