Organization Active NPI

Rogece a Professional Medical Corporation

  • Family Medicine Physician
  • Northridge, CA
National Provider Identifier
1194837518
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A76791 Issued in CA
Legal business name
ROGECE A PROFESSIONAL MEDICAL CORPORATION
Practice address
18433 Roscoe Blvd
Suite 103
Northridge, CA 91325-4108
Phone
(818) 734-7620
Fax
(818) 734-7621
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Cesar A. Vega, M.D.NPI 1093736548
Title
Director
Phone
(818) 734-7620

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X A76791 CA Primary

Addresses

Primary practice location

18433 Roscoe Blvd
Suite 103
Northridge, CA 91325-4108

Mailing address

18433 Roscoe Blvd
Suite 103
Northridge, CA 91325-4108
Phone (818) 734-7620

Other identifiers 1

IdentifierTypeStateIssuer
0A767910MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060126001058 CA Part B Supplier - Clinic/Group Practice 1153335310 Receives reassigned benefits from 1 practitioner
Practice locations: Northridge, CA

National Provider Directory

National Provider Directory

Locations

18433 Roscoe Blvd
Ste 103
Northridge, CA 91325
Phone (818) 734-7620

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or 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-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194837518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18433 ROSCOE BLVD",
            "address_2": "SUITE 103",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913254108",
            "telephone_number": "818-734-7620",
            "fax_number": "818-734-7621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18433 ROSCOE BLVD",
            "address_2": "SUITE 103",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913254108",
            "telephone_number": "818-734-7620",
            "fax_number": "818-734-7621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROGECE A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VEGA",
        "authorized_official_first_name": "CESAR",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "818-734-7620",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A76791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0A767910",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Northridge, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.