Individual provider Active NPI

Roxanne Zubin Mistry, MD

  • Pediatrics Physician
  • Tarzana, CA
National Provider Identifier
1215990692
Registry record updated Mar 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A93759 Issued in CA
Practice address
18321 Clark St
Tarzana, CA 91356-3501
Phone
(702) 697-0082
Fax
(702) 369-5827
NPI assigned
Apr 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A93759 CA Primary

Addresses

Primary practice location

18321 Clark St
Tarzana, CA 91356-3501

Mailing address

3006 S Maryland Pkwy
505
Las Vegas, NV 89109-2218
Phone (702) 697-0082

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A93759CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Partners Affiliates Medical Group Past Accepting new patients
Pediatrix Medical Group of California, a Professional Corporation Pediatrics Past Accepting new patients
Memorial Medical Group Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: roxanne.mistry.p1@direct.lakeside.nextgenshare.com

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": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236556800000",
    "number": "1215990692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3006 S MARYLAND PKWY",
            "address_2": "505",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891092218",
            "telephone_number": "702-697-0082",
            "fax_number": "702-369-5827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18321 CLARK ST",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563501",
            "telephone_number": "702-697-0082",
            "fax_number": "702-369-5827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISTRY",
        "first_name": "ROXANNE",
        "middle_name": "ZUBIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-07",
        "last_updated": "2009-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A93759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarzana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2009; 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.