Individual provider Active NPI

Roman Esteban Mayek

  • Family Medicine Physician
  • Porterville, CA
National Provider Identifier
1013483882
Registry record updated Sep 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
PA57120 Issued in CA
Practice address
1107 W Poplar Ave
Porterville, CA 93257-5839
Phone
(877) 960-3426
NPI assigned
Oct 19, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X PA57120 CA Primary

Addresses

Primary practice location

1107 W Poplar Ave
Porterville, CA 93257-5839

Mailing address

305 E Center Ave
Visalia, CA 93291-6331
Phone (877) 960-3426

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191029002439 CA Practitioner - Physician Assistant 7113259854 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
57120CAMDGeneral Practice Dentistry
PA57120CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Healthcare Network CurrentSince Sep 24, 2019 Accepting new patients
Family Healthcare Network Current Accepting new patients
Family Healthcare Network Current Accepting new patients
Family Healthcare Network Current Accepting new patients
Family Healthcare Network Current Accepting new patients
Family Healthcare Network Current Accepting new patients
Family Healthcare Network CurrentSince Sep 24, 2019 Accepting new patients
Family Healthcare Network Past Accepting new patients

Locations

1107 W Poplar Ave
Porterville, CA 93257
Phone (559) 781-7242

305 E Center Ave
Visalia, CA 93291
Phone (559) 737-4792

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CCECCA

Organizations & group practices 9

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": "1539907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569196800000",
    "number": "1013483882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 E CENTER AVE",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932916331",
            "telephone_number": "877-960-3426",
            "fax_number": "559-734-1247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 W POPLAR AVE",
            "city": "PORTERVILLE",
            "state": "CA",
            "postal_code": "932575839",
            "telephone_number": "877-960-3426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYEK",
        "first_name": "ROMAN",
        "middle_name": "ESTEBAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-19",
        "last_updated": "2019-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "PA57120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Porterville, CA

Sources for this page

Verify at the official NPI Registry.