Organization Active NPI

Rose Avenue Family Medical Group a Professional Corporation

  • Family Medicine Physician
  • Oxnard, CA
National Provider Identifier
1114019015
Registry record updated Aug 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ROSE AVENUE FAMILY MEDICAL GROUP A PROFESSIONAL CORPORATION
Practice address
451 W Gonzales Rd Ste 230
Oxnard, CA 93036
Phone
(805) 988-1443
Fax
(805) 988-0897
NPI assigned
Sep 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2018

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

Authorized official

Name
Dr. Josephine Soliz, M.D.
Title
President
Phone
(805) 988-1443

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

451 W Gonzales Rd Ste 230
Oxnard, CA 93036

Mailing address

451 W Gonzales Rd Ste 230
Oxnard, CA 93036-0726
Phone (805) 988-1443

Other identifiers 2

IdentifierTypeStateIssuer
ZZZ38731ZOtherCABLUE SHIELD GROUP NUMBER
GR0028670MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040729001582 CA Part B Supplier - Clinic/Group Practice 1254301096 Receives reassigned benefits from 7 practitioners
Practice locations: Oxnard, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0932496Rose Avenue Family Medical Group451 W Gonzales Rd Ste 230, Oxnard, CA 93036Provider-performed microscopyAug 20, 2027

National Provider Directory

National Provider Directory

Locations

451 W Gonzales Rd
Oxnard, CA 93036
Phone (805) 658-9500

451 W Gonzales Rd
Ste 230
Oxnard, CA 93036
Phone (805) 988-1433

1100 W Gonzales Rd
Ste 210
Oxnard, CA 93036
Phone (805) 988-1443

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534723200000",
    "number": "1114019015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 W GONZALES RD STE 230",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930360726",
            "telephone_number": "805-988-1443",
            "fax_number": "805-988-0897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 W GONZALES RD STE 230",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "93036",
            "telephone_number": "805-988-1443",
            "fax_number": "805-988-0897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSE AVENUE FAMILY MEDICAL GROUP A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2018-08-20",
        "status": "A",
        "authorized_official_last_name": "SOLIZ",
        "authorized_official_first_name": "JOSEPHINE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-988-1443",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD GROUP NUMBER",
            "identifier": "ZZZ38731Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0028670",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxnard, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.