Roberta Joy Hayertz, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A-25515 Issued in CA

Practice address

912 Printz Rd
Arroyo Grande, CA 93420-5026

Phone

(805) 473-0297

NPI assigned

Aug 21, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1345507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345507200000",
    "number": "1184972226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1419",
            "city": "ARROYO GRANDE",
            "state": "CA",
            "postal_code": "934211419",
            "telephone_number": "805-473-0297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 PRINTZ RD",
            "city": "ARROYO GRANDE",
            "state": "CA",
            "postal_code": "934205026",
            "telephone_number": "805-473-0297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYERTZ",
        "first_name": "ROBERTA",
        "middle_name": "JOY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-21",
        "last_updated": "2012-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A-25515",
            "primary": true
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "CA",
            "license": "A-25515",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A-25515",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Arroyo Grande, CA
• Providers in Arroyo Grande, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.