Individual provider Active NPI

Jennifer Jane Roelands, MD

  • Obstetrics & Gynecology Physician
  • Fullerton, CA
National Provider Identifier
1164695409
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
2008013765 Issued in MO
Practice address
301 W Bastanchury Rd Ste 140
Fullerton, CA 92835-3427
Phone
(714) 272-3477
NPI assigned
Apr 8, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VG0400X C169554 CA
Obstetrics & Gynecology Physician 207V00000X 2008013765 MO Primary
Obstetrics & Gynecology Physician 207V00000X C169555 AR

Addresses

Primary practice location

301 W Bastanchury Rd Ste 140
Fullerton, CA 92835-3427

Mailing address

1830 Calle Don Guillermo
La Habra, CA 90631-7616
Phone (573) 355-6835

Electronic endpoints 2

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group
CONNECT URL www.precisionhealthmdoc.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, CA, AR3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20080719000009 MO Practitioner - Obstetrics/Gynecology 3870666159 Reassigns benefits to 1 organization
I20210720001859 CA Practitioner - Obstetrics/Gynecology 3870666159 Reassigns benefits to 5 organizations
I20230428001542 AR Practitioner - Obstetrics/Gynecology 3870666159 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of California, San Diego School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

270 Laguna Rd
Suite 220
Fullerton, CA 92835-2521
Phone (714) 272-3477

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C169555ARMDObstetrics & Gynecology Physician
C169554CAMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group Single Specialty CurrentSince Jan 3, 2023 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jan 3, 2023 Accepting new patients
Arkansas Health Group Single Specialty CurrentSince Apr 28, 2023 Accepting new patients
Los Angeles County Department of Public Health Single Specialty CurrentSince Nov 15, 2023 Accepting new patients
Arkansas Health Group Single Specialty CurrentSince Apr 28, 2023 Accepting new patients
Precision Health MD Inc Single Specialty CurrentSince Aug 23, 2023 Accepting new patients
University of California San Francisco Single Specialty CurrentSince Jul 12, 2021 Accepting new patients
University of California San Francisco CurrentSince Jul 12, 2021 Accepting new patients
UCSF Medical Group Business Services CurrentSince Jul 12, 2021 Accepting new patients
UCSF Medical Group Business Services Single Specialty CurrentSince Jul 12, 2021 Accepting new patients
University of California San Francisco Single Specialty Current Accepting new patients
Southern California Permanente Medical Group Single Specialty Current Accepting new patients
Precision Health Inc Past Accepting new patients
CH Allied Services, Inc. Past Accepting new patients
University of California San Francisco Past Accepting new patients
Conway Community Services Past Accepting new patients

Locations

625 United Dr
Ste 420
Conway, AR 72032
Phone (501) 358-6941

9601 Baptist Health Dr
Little Rock, AR 72205
Phone (501) 202-3995

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

9601 Baptist Health Dr
Ste 700
Little Rock, AR 72205
Phone (501) 219-1970

5555 Ferguson Dr
Ste 10050
Commerce, CA 90022
Phone (213) 240-8220

301 W Bastanchury Rd
Ste 140
Fullerton, CA 92835
Phone (714) 773-0111

270 Laguna Rd
Ste 220
Fullerton, CA 92835
Phone (714) 272-3477

335 E Avenue K6
Ste B
Lancaster, CA 93535
Phone (661) 471-4810

241 N Figueroa St
Los Angeles, CA 90012
Phone (213) 240-8204

393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914

10800 Magnolia Ave
Riverside, CA 92505
Phone (951) 353-2000

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

Organizations & group practices 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1207612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1164695409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 CALLE DON GUILLERMO",
            "city": "LA HABRA",
            "state": "CA",
            "postal_code": "906317616",
            "telephone_number": "573-355-6835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 W BASTANCHURY RD STE 140",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353427",
            "telephone_number": "714-272-3477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROELANDS",
        "first_name": "JENNIFER",
        "middle_name": "JANE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-08",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "CA",
            "license": "C169554",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "2008013765",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AR",
            "license": "C169555",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "10800 Magnolia Ave",
            "city": "Riverside",
            "state": "CA",
            "country_code": "US",
            "postal_code": "925053043",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.precisionhealthmdoc.com",
            "affiliation": "N",
            "endpointDescription": "websut",
            "address_1": "301 W Bastanchury Rd Ste 140",
            "city": "Fullerton",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928353427",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

Verify at the official NPI Registry.