Roseanne E Pevec, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

G74507 Issued in CA

Practice address

2725 Capitol Ave
#404
Sacramento, CA 95816-6004

Phone

(916) 262-9456

Fax

(916) 262-9460

NPI assigned

Sep 16, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Sutter Valley Medical Foundation

  • Multi-Specialty Clinic/Center
  • Modesto, CA
  • NPI 1669846986

  Otolaryngology

  Medicare reassignment NPD

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438128000000",
    "number": "1184720245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10470 OLD PLACERVILLE RD",
            "address_2": "SUITE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272539",
            "telephone_number": "800-470-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2725 CAPITOL AVE",
            "address_2": "#404",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958166004",
            "telephone_number": "916-262-9456",
            "fax_number": "916-262-9460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEVEC",
        "first_name": "ROSEANNE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-16",
        "last_updated": "2015-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "G74507",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G745070",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tara Sekle Pettus
• Ashley Petty
• Raymond P. Petty, DPM
• Jason Petusevsky, DO
• Jacob Richard Petway, DC, QME, IIE, BS
• William Charles Pevec, M.D.
• Nayereh G Pezeshkian
• Kevin Timothy Pfaff, RN
• Alisa Anne Pfanner
• Emma Grace Pfeffer, IBCLC

• Otolaryngology Physician in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Otolaryngology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.