Individual provider Active NPI

Roxann Esther Wuest

  • Physician Assistant
  • Pomona, CA
National Provider Identifier
1316168578
Registry record updated Aug 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA15646 Issued in CA
Practice address
716 E Mission Blvd
Pomona, CA 91766-7203
Phone
(909) 865-2332
NPI assigned
May 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA15646 CA Primary

Addresses

Primary practice location

716 E Mission Blvd
Pomona, CA 91766-7203

Mailing address

716 E Mission Blvd
Pomona, CA 91766-7203
Phone (909) 865-2332

Other names 1

  • Mrs. Roxann Esther Robles Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140428000474 CA Practitioner - Physician Assistant 6204069271 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Luis Perez M D a Professional CorporationGroup PAC ID 7810882453, 3 clinicians

Practice addresses (Care Compare)

2776 N Garey Ave
Pomona, CA 91767-1810
Phone (909) 865-2332

720 Magnolia Ave
Suite B1
Corona, CA 92879-3119
Phone (951) 735-1712

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA15646CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Fenix Health Medical Group, Inc. PastSince Aug 9, 2020 Accepting new patients
Luis Perez, M.D., a Professional Corporation Past Accepting new patients
Dignity Health Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596672000000",
    "number": "1316168578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 E MISSION BLVD",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917667203",
            "telephone_number": "909-865-2332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 E MISSION BLVD",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917667203",
            "telephone_number": "909-865-2332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WUEST",
        "first_name": "ROXANN",
        "middle_name": "ESTHER",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2020-08-06",
        "certification_date": "2020-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA15646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROXANN",
            "last_name": "ROBLES",
            "middle_name": "ESTHER",
            "prefix": "MRS.",
            "credential": "P.A. C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.