Individual provider Active NPI

Justin Payom Rouintan, DO

  • Family Medicine Physician
  • Paradise Valley, AZ
National Provider Identifier
1073205043
Registry record updated Jun 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R4141 Issued in AZ
Practice address
8732 N 66TH PL
Paradise Valley, AZ 85253-2304
Phone
(602) 502-0062
NPI assigned
May 25, 2023
Last updated
Jun 3, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2023

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 R4141 AZ Primary

Addresses

Primary practice location

8732 N 66TH PL
Paradise Valley, AZ 85253-2304

Mailing address

8732 N 66TH PL
Paradise Valley, AZ 85253-2304
Phone (602) 502-0062

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
R4141AZMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1684972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685750400000",
    "number": "1073205043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8732 N 66TH PL",
            "city": "PARADISE VALLEY",
            "state": "AZ",
            "postal_code": "852532304",
            "telephone_number": "602-502-0062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8732 N 66TH PL",
            "city": "PARADISE VALLEY",
            "state": "AZ",
            "postal_code": "852532304",
            "telephone_number": "602-502-0062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUINTAN",
        "first_name": "JUSTIN",
        "middle_name": "PAYOM",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-25",
        "last_updated": "2023-06-03",
        "certification_date": "2023-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "R4141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paradise Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.