Individual provider Active NPI

John Martin Roesler, M.D.

  • Specialist
  • Calabasas, CA
National Provider Identifier
1124037635
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A72319 Issued in CA
Practice address
24025 Park Sorrento
Suite 405
Calabasas, CA 91302
Phone
(818) 609-7200
Fax
(855) 754-3775
NPI assigned
Aug 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A72319 CA Primary

Addresses

Primary practice location

24025 Park Sorrento
Suite 405
Calabasas, CA 91302

Mailing address

24025 Park Sorrento
Suite 405
Calabasas, CA 91302
Phone (818) 609-7200

Other identifiers 1

IdentifierTypeStateIssuer
201118042OtherCATAX ID

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040624001277 CA Practitioner - Otolaryngology 5698751394 Reassigns benefits to 1 organization
Practice locations: Calabasas, CA

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of California, Geffen School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

24025 Park Sorrento
Suite 405
Calabasas, CA 91302-4037
Phone (818) 609-7200

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A72319CAMDSpecialist
72319CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Csi Medical Group CurrentSince Dec 15, 2023 Accepting new patients
MD Surgical Solutions, LLC CurrentSince Jun 16, 2014 Accepting new patients
Vera D. Cecilio, M.D. Inc. PastSince Aug 9, 2010 Accepting new patients
Montage Medical Group PastSince Apr 6, 2021 Accepting new patients

Locations

23975 Park Sorrento
Ste 355
Calabasas, CA 91302
Phone (818) 222-2055

24025 Park Sorrento
Ste 405
Calabasas, CA 91302
Phone (818) 222-2055

15477 Ventura Blvd
Ste 103
Sherman Oaks, CA 91403
Phone (818) 641-1214

28049 Smyth Dr
Valencia, CA 91355
Phone (661) 705-9706

Interoperability endpoints

  • Direct secure messaging: jroesler25818@direct.uclahealth.org

Organizations & group practices 4

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": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1124037635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24025 PARK SORRENTO",
            "address_2": "SUITE 405",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "91302",
            "telephone_number": "818-609-7200",
            "fax_number": "855-754-3775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24025 PARK SORRENTO",
            "address_2": "SUITE 405",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "91302",
            "telephone_number": "818-609-7200",
            "fax_number": "855-754-3775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROESLER",
        "first_name": "JOHN",
        "middle_name": "MARTIN",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A72319",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "201118042",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Calabasas, CA

Sources for this page

Verify at the official NPI Registry.