Individual provider Active NPI

Walter Thomas Roschek III

  • Certified Registered Nurse Anesthetist
  • San Diego, CA
National Provider Identifier
1245911429
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
95002215 Issued in CA
Practice address
200 W Arbor Dr
San Diego, CA 92103-9000
Phone
(800) 926-8273
Fax
(888) 539-8781
NPI assigned
Jul 31, 2023
Last updated
Oct 30, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 95002215 CA Primary
Critical Care Medicine Registered Nurse 163WC0200X 95137458 CA

Addresses

Primary practice location

200 W Arbor Dr
San Diego, CA 92103-9000

Mailing address

PO Box 232410
San Diego, CA 92193-2410
Phone (800) 926-8273

Other practice location 1

1700 Mount Vernon Ave
Bakersfield, CA 93306-4018
Phone (661) 326-2000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231024001709 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 4789030941 Reassigns benefits to 11 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regional Anesthesia Associates IncGroup PAC ID 7810275096, 45 clinicians
Samantha Polikowski Anesthesia IncGroup PAC ID 1951742543, 36 clinicians
Sound Physicians Anesthesiology of California PCGroup PAC ID 4385027770, 35 clinicians
Coachella Valley Anesthesia a Professional CorporationGroup PAC ID 5698131969, 126 clinicians

Practice addresses (Care Compare)

1700 Mount Vernon Ave
Bakersfield, CA 93306-4018
Phone (661) 326-2000

2130 Citracado Pkwy
Escondido, CA 92029-4149
Phone (858) 485-1111

4002 Vista Way
Oceanside, CA 92056-4506
Phone (760) 724-8411

420 34TH St
Bakersfield, CA 93301-2237
Phone (661) 324-4647

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.41 of 100Reported as group
Quality
87.02
Promoting interoperability
100
Improvement activities
40
Cost
78.21

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95137458CAMDCritical Care Medicine Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Community Foundation Medical Group CurrentSince Nov 19, 2023 Accepting new patients
Relevo Health PC CurrentSince Oct 9, 2024 Accepting new patients
Coachella Valley Anesthesia a Professional Corporation Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2024 Accepting new patients
Relevo Health PC CurrentSince Oct 9, 2024 Accepting new patients
Community Foundation Medical Group CurrentSince Nov 19, 2023 Accepting new patients
Anesthesia Medical Group of Imperial Valley, Inc. CurrentSince Jun 6, 2025 Accepting new patients
Escondido Anesthesia Associates LP Nurse Anesthetist, Certified Registered CurrentSince Aug 11, 2024 Accepting new patients
La Jolla Anesthesia Associates LP Nurse Anesthetist, Certified Registered CurrentSince Feb 6, 2024 Accepting new patients
Excelle Anesthesia Services, Inc. CurrentSince Jan 13, 2025 Accepting new patients
Sound Physicians Anesthesiology of California PC Nurse Anesthetist, Certified Registered CurrentSince May 9, 2025 Accepting new patients
Community Foundation Medical Group Current Accepting new patients
Regional Anesthesia Associates Inc CurrentSince Sep 10, 2023 Accepting new patients
Samantha Polikowski Anesthesia Inc Nurse Anesthetist, Certified Registered CurrentSince Jan 13, 2026 Accepting new patients
HP Anesthesia Inc Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2024 Accepting new patients

Locations (25 of 34)

1700 Mount Vernon Ave
Bakersfield, CA 93306
Phone (616) 326-2000

2215 Truxtun Ave
Bakersfield, CA 93301
Phone (661) 477-9283

420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647

9300 Stockdale Hwy
Ste 200
Bakersfield, CA 93311
Phone (661) 663-3700

195 W Legion Rd
Brawley, CA 92227
Phone (760) 251-8669

207 W Legion Rd
Brawley, CA 92227
Phone (760) 351-3333

751 W Legion Rd
Ste 103
Brawley, CA 92227
Phone (760) 344-8750

835 Third Ave
Ste A
Chula Vista, CA 91911
Phone (619) 425-7755

2130 Citracado Pkwy
Escondido, CA 92029
Phone (858) 485-1111

488 E Valley Pkwy
Ste 110
Escondido, CA 92025
Phone (760) 735-6290

700 W El Norte Pkwy
Escondido, CA 92026
Phone (760) 738-7830

1351 E Spruce Ave
Fresno, CA 93720
Phone (559) 432-3303

1630 E Herndon Ave
Ste 100
Fresno, CA 93720
Phone (559) 449-2888

1660 E Herndon Ave
Ste 102
Fresno, CA 93720
Phone (559) 840-2262

1843 E Fir Ave
Ste 104
Fresno, CA 93720
Phone (559) 323-6611

2335 E Kashian Ln
Ste 270
Fresno, CA 93701
Phone (559) 445-1251

540 E Herndon Ave
Ste 102
Fresno, CA 93720
Phone (559) 442-0855

6125 N Fresno St
Fresno, CA 93710
Phone (559) 285-9344

27200 Calaroga Ave
Hayward, CA 94545
Phone (510) 264-2000

47111 Monroe St
Indio, CA 92201
Phone (760) 347-6191

6601 White Feather Rd
Joshua Tree, CA 92252
Phone (760) 366-1500

9850 Genesee Ave
Ste 980
La Jolla, CA 92037
Phone (858) 453-7525

47120 Dune Palms Rd
Ste 111
La Quinta, CA 92253
Phone (760) 219-0155

44815 Fig Ave
Ste 100
Lancaster, CA 93534
Phone (661) 802-7978

1300 N Vermont Ave
Los Angeles, CA 90027
Phone (213) 413-3000

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1690761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1245911429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 232410",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921932410",
            "telephone_number": "800-926-8273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "800-926-8273",
            "fax_number": "888-539-8781"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 Mount Vernon Ave",
            "address_purpose": "LOCATION",
            "city": "Bakersfield",
            "state": "CA",
            "postal_code": "933064018",
            "country_code": "US",
            "telephone_number": "661-326-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSCHEK",
        "first_name": "WALTER",
        "middle_name": "THOMAS",
        "name_suffix": "III",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-31",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "95002215",
            "primary": true
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "CA",
            "license": "95137458",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.