Individual provider Active NPI

Rosana Jennifer Ayoub, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Sylmar, CA
National Provider Identifier
1255658746
Registry record updated Feb 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
A119909 Issued in CA
Practice address
14445 Olive View Dr
Sylmar, CA 91342-1437
Phone
(818) 364-3205
NPI assigned
Apr 23, 2010
Last updated
Feb 23, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Endocrinology, Diabetes & Metabolism Physician 207RE0101X A119909 CA Primary

Addresses

Primary practice location

14445 Olive View Dr
Sylmar, CA 91342-1437

Mailing address

26842 Fond Du Lac Rd
Rancho Palos Verdes, CA 90275-2359
Phone (310) 940-1028

Other practice location 1

22330 Hawthorne Blvd Ste 216
Torrance, CA 90505-2544
Phone (310) 375-7666

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
I20151123001587 CA Practitioner - Endocrinology 3072813039 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Loma Linda University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Endocrine Care Specialists IncGroup PAC ID 3072823459, 2 clinicians

Practice addresses (Care Compare)

24805 Narbonne Ave
Lomita, CA 90717-1525
Phone (310) 375-7666

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A119909CAMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endocrine Care Specialists, Inc Single Specialty CurrentSince Sep 26, 2015 Accepting new patients
Lakeside Medical Organization, a Medical Group Inc. Single Specialty CurrentSince Feb 15, 2016 Accepting new patients
Torrance Memorial Medical Center Past Accepting new patients

Locations

191 S Buena Vista St
Ste 200
Burbank, CA 91505
Phone (818) 887-2671

24805 Narbonne Ave
Lomita, CA 90717
Phone (310) 375-7666

8510 Balboa Blvd
Ste 150
Northridge, CA 91325
Phone (818) 637-2000

22330 Hawthorne Blvd
Ste 207
Torrance, CA 90505
Phone (310) 375-7666

22330 Hawthorne Blvd
Ste 216
Torrance, CA 90505
Phone (310) 375-7666

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: rosana.ayoub.1@29913.direct.athenahealth.com
  • Direct secure messaging: rosana.ayoub.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1271980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1255658746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26842 FOND DU LAC RD",
            "city": "RANCHO PALOS VERDES",
            "state": "CA",
            "postal_code": "902752359",
            "telephone_number": "310-940-1028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14445 OLIVE VIEW DR",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913421437",
            "telephone_number": "818-364-3205"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22330 Hawthorne Blvd Ste 216",
            "address_purpose": "LOCATION",
            "city": "Torrance",
            "state": "CA",
            "postal_code": "905052544",
            "country_code": "US",
            "telephone_number": "310-375-7666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AYOUB",
        "first_name": "ROSANA",
        "middle_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-23",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "A119909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylmar, CA

Sources for this page

Verify at the official NPI Registry.