Individual provider Active NPI

Joel Roberts, PA-S

  • Physician Assistant
  • Temecula, CA
National Provider Identifier
1013649797
Registry record updated Nov 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
30589 Temecula Pkwy
Temecula, CA 92592-2840
Phone
(951) 412-1540
Fax
(951) 412-1541
NPI assigned
Jun 30, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

30589 Temecula Pkwy
Temecula, CA 92592-2840

Mailing address

PO Box 16297
Beverly Hills, CA 90209-2297
Phone (661) 388-5240

Other practice location 1

650 E Parkway S
Memphis, TN 38104-5568
Phone (901) 321-3000

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
I20230918003260 CA Practitioner - Physician Assistant 1850755281 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
La Laser Center PC a Professional Medical CorporationGroup PAC ID 9537181185, 81 clinicians

Practice addresses (Care Compare)

30589 Temecula Pkwy
Temecula, CA 92592-2840
Phone (951) 412-1540

40663 Murrieta Hot Springs Rd
Suite C3
Murrieta, CA 92562-9015
Phone (951) 677-5341

621 W Line St
Suite 105
Bishop, CA 93514-3320
Phone (760) 873-8781

74320 Hwy 111
Suite 100
Palm Desert, CA 92260-4140
Phone (760) 423-5610

Merit-based Incentive Payment System (MIPS)

Final score
91.69 of 100Reported as group
Quality
91.59
Promoting interoperability
94
Improvement activities
40
Cost
76.9

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
La Laser Center PC, a Professional Medical Corporation PastSince Feb 1, 2020 Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: jroberts@lalasercenter.emadirect.md

Organizations & group practices 2

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": "1656547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1013649797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16297",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902092297",
            "telephone_number": "661-388-5240",
            "fax_number": "424-458-4201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30589 TEMECULA PKWY",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925922840",
            "telephone_number": "951-412-1540",
            "fax_number": "951-412-1541"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "650 E Parkway S",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381045568",
            "country_code": "US",
            "telephone_number": "901-321-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "JOEL",
        "credential": "PA-S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-30",
        "last_updated": "2023-11-02",
        "certification_date": "2023-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temecula, CA

Sources for this page

Verify at the official NPI Registry.