Individual provider Active NPI

Jackson Roos, MD

  • Emergency Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1023694973
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
345649 Issued in LA
Practice address
1200 N State St
Los Angeles, CA 90089-1001
Phone
(207) 749-7690
NPI assigned
Mar 22, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X LA
Emergency Medicine Physician 207P00000X 345649 LA Primary

Addresses

Primary practice location

1200 N State St
Los Angeles, CA 90089-1001

Mailing address

1200 N State St # 1060K
Los Angeles, CA 90089-1001
Phone (207) 749-7690

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, LA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20241223002809 CA Practitioner - Emergency Medicine 8628519873 Reassigns benefits to 1 organization
I20250404000470 LA Practitioner - Emergency Medicine 8628519873 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Tulane University School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Belle Chasse Emergency Group LLCGroup PAC ID 7113140070, 95 clinicians

Practice addresses (Care Compare)

2500 Belle Chasse Hwy
Terrytown, LA 70056-7127
Phone (504) 392-3131

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kenner Emergency Group LLC Emergency Medicine CurrentSince May 1, 2025 Accepting new patients
Pinnacle Emergency Physicians of Bakersfield, a Professional Corp Emergency Medicine CurrentSince Jan 1, 2025 Accepting new patients
Belle Chasse Emergency Group LLC Emergency Medicine CurrentSince May 1, 2025 Accepting new patients
Luling Emergency Group LLC Emergency Medicine CurrentSince May 1, 2025 Accepting new patients
Pinnacle Emergency Physicians of Bakersfield, a Professional Corp Emergency Medicine CurrentSince Jan 1, 2025 Accepting new patients
St. John Emergency Group LLC Emergency Medicine CurrentSince May 1, 2025 Accepting new patients

Locations

420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647

180 W Esplanade Ave
Kenner, LA 70065
Phone (504) 464-8284

1900 W Airline Hwy
La Place, LA 70068
Phone (985) 652-7000

200 Corporate Blvd
Lafayette, LA 70508

1057 Paul Maillard Rd
Luling, LA 70070
Phone (985) 785-3655

1514 Jefferson Hwy
New Orleans, LA 70121

2500 Belle Chasse Hwy
Terrytown, LA 70056
Phone (504) 391-5157

Interoperability endpoints

  • Direct secure messaging: jroos2444301@direct.ochsner.org

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1616371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1023694973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N STATE ST # 1060K",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900891001",
            "telephone_number": "207-749-7690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N STATE ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900891001",
            "telephone_number": "207-749-7690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROOS",
        "first_name": "JACKSON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-22",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "LA",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "345649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.