Individual provider Active NPI

Jordan Aaron Roberts, D.O.

  • Emergency Medicine Physician
  • Bakersfield, CA
National Provider Identifier
1164780151
Registry record updated Jul 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
20A11940 Issued in CA
Practice address
1700 Mount Vernon Ave
Bakersfield, CA 93306-4018
Phone
(661) 326-2000
NPI assigned
Apr 26, 2012
Last updated
Jul 6, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 20A11940 CA Primary

Addresses

Primary practice location

1700 Mount Vernon Ave
Bakersfield, CA 93306-4018

Mailing address

1700 Mount Vernon Ave
Bakersfield, CA 93306-4018
Phone (661) 326-2000

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
I20130521000385 CA Practitioner - Emergency MedicinePractitioner - Osteopathic Manipulative Medicine 2163660796 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Western University of Health Sciences College of Dental Med, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Team Physicians of California Medical Group IncGroup PAC ID 8224945084, 92 clinicians

Practice addresses (Care Compare)

215 W Janss Rd
Thousand Oaks, CA 91360-1847
Phone (805) 497-2727

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Team Physicians of California Medical Group Inc Emergency Medicine CurrentSince Jun 1, 2024 Accepting new patients

Locations

215 W Janss Rd
Thousand Oaks, CA 91360
Phone (805) 379-5435

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1335398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341532800000",
    "number": "1164780151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 MOUNT VERNON AVE",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933064018",
            "telephone_number": "661-326-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 MOUNT VERNON AVE",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933064018",
            "telephone_number": "661-326-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "JORDAN",
        "middle_name": "AARON",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-26",
        "last_updated": "2012-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20A11940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

Verify at the official NPI Registry.