Individual provider Active NPI

Roupen Yaghsezian, MD

  • Dermatopathology (Pathology) Physician
  • Laguna Niguel, CA
National Provider Identifier
1215051669
Registry record updated May 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology (Pathology) PhysicianTaxonomy code 207ZD0900X
License
A52567 Issued in CA
Practice address
22632 Ocean Way
Laguna Niguel, CA 92677-5436
Phone
(951) 280-0100
Fax
(951) 280-0194
NPI assigned
Mar 19, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology (Pathology) Physician 207ZD0900X A52567 CA Primary

Addresses

Primary practice location

22632 Ocean Way
Laguna Niguel, CA 92677-5436

Mailing address

22632 Ocean Way
Laguna Niguel, CA 92677-5436
Phone (951) 280-0100

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
I20050711000917 CA Practitioner - Pathology 7517951759 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

22632 Ocean Way
Laguna Niguel, CA 92677-5436
Phone (951) 280-0100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A52567CAMDDermatopathology (Pathology) Physician
52567CAMDPhysician Assistant

Organizations & group practices 1

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": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525651200000",
    "number": "1215051669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22632 OCEAN WAY",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926775436",
            "telephone_number": "951-280-0100",
            "fax_number": "951-280-0194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22632 OCEAN WAY",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926775436",
            "telephone_number": "951-280-0100",
            "fax_number": "951-280-0194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAGHSEZIAN",
        "first_name": "ROUPEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2018-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "CA",
            "license": "A52567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Niguel, CA

Sources for this page

Verify at the official NPI Registry.