Individual provider Active NPI

Peter Jonathan Rogers, MD

  • General Practice Physician
  • Irvine, CA
National Provider Identifier
1225074545
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A47822 Issued in CA
Practice address
19900 Macarthur Blvd Ste 800
Irvine, CA 92612-8423
Phone
(877) 693-6266
NPI assigned
Jun 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X A47822 CA Primary

Addresses

Primary practice location

19900 Macarthur Blvd Ste 800
Irvine, CA 92612-8423

Mailing address

530 Via Estrada Unit N
Laguna Woods, CA 92637-4033
Phone (949) 236-9533

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
I20250708001473 CA Practitioner - General Practice 1153330105 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
47822CAMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Marque Medical Clinic, Inc. CurrentSince Apr 19, 2025 Accepting new patients
Marque Medical Clinic, Inc CurrentSince Apr 19, 2025 Accepting new patients

Locations

26831 Aliso Creek Rd
Ste 200
Aliso Viejo, CA 92656
Phone (949) 235-9375

9630 Sierra Ave
#100
Fontana, CA 92335
Phone (877) 693-6266

21770 LK FRST Dr
Ste 109
Lake Forest, CA 92630
Phone (877) 693-6266

2075 San Joaquin Hills Rd
Newport Beach, CA 92660
Phone (877) 693-6266

4490 Fanuel St
Ste 100
San Diego, CA 92109

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1225074545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 VIA ESTRADA UNIT N",
            "city": "LAGUNA WOODS",
            "state": "CA",
            "postal_code": "926374033",
            "telephone_number": "949-236-9533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19900 MACARTHUR BLVD STE 800",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926128423",
            "telephone_number": "877-693-6266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "PETER",
        "middle_name": "JONATHAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A47822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.