Individual provider Active NPI

Xenia Almira Roldan, M.D.

  • Pediatrics Physician
  • Lamont, CA
National Provider Identifier
1174634307
Registry record updated Jun 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A55237 Issued in CA
Practice address
8787 Hall Rd
Lamont, CA 93241-1953
Phone
(661) 845-3731
Fax
(661) 845-1157
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X AO55237 CA
Pediatrics Physician 208000000X A55237 CA Primary

Addresses

Primary practice location

8787 Hall Rd
Lamont, CA 93241-1953

Mailing address

8787 Hall Rd
Lamont, CA 93241-1953
Phone (661) 845-3731

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
I20190502001363 CA Practitioner - Pediatric Medicine 6709128275 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A55237CAMDPediatrics Physician
AO55237CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clinica Sierra Vista CurrentSince Jun 10, 2022 Accepting new patients
Clinica Sierra Vista Current Accepting new patients
Clinica Sierra Vista CurrentSince Jun 10, 2022 Accepting new patients

Locations

1305 Bear Mountain Blvd
Arvin, CA 93203
Phone (661) 854-3131

8787 Hall Rd
Lamont, CA 93241
Phone (661) 845-3717

Organizations & group practices 3

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654214400000",
    "number": "1174634307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8787 HALL RD",
            "city": "LAMONT",
            "state": "CA",
            "postal_code": "932411953",
            "telephone_number": "661-845-3731",
            "fax_number": "661-845-1157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8787 HALL RD",
            "city": "LAMONT",
            "state": "CA",
            "postal_code": "932411953",
            "telephone_number": "661-845-3731",
            "fax_number": "661-845-1157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLDAN",
        "first_name": "XENIA",
        "middle_name": "ALMIRA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2022-06-03",
        "certification_date": "2022-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "AO55237",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A55237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lamont, CA

Sources for this page

Verify at the official NPI Registry.