Individual provider Active NPI

Monifa Tamu Martin-Roberts, PA

  • Physician Assistant
  • El Monte, CA
National Provider Identifier
1326056466
Registry record updated Jul 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA17207 Issued in CA
Practice address
9350 Flair Dr Ste 102
El Monte, CA 91731-2828
Phone
(626) 407-0300
NPI assigned
Aug 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2016

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 PA17207 CA Primary

Addresses

Primary practice location

9350 Flair Dr Ste 102
El Monte, CA 91731-2828

Mailing address

2118 S Mountain Ave
Ontario, CA 91762-6126
Phone (909) 988-9651

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
I20200207000969 CA Practitioner - Physician Assistant 3072805506 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastside Orthopedic Medical AssociatesGroup PAC ID 1254340524, 6 clinicians

Practice addresses (Care Compare)

880 S Atlantic Blvd
Suite 205
Monterey Park, CA 91754-4782
Phone (626) 289-0178

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA17207CAMDPhysician Assistant

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 1

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": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468368000000",
    "number": "1326056466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2118 S MOUNTAIN AVE",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917626126",
            "telephone_number": "909-988-9651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9350 FLAIR DR STE 102",
            "city": "EL MONTE",
            "state": "CA",
            "postal_code": "917312828",
            "telephone_number": "626-407-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN-ROBERTS",
        "first_name": "MONIFA",
        "middle_name": "TAMU",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2016-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA17207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Monte, CA

Sources for this page

Verify at the official NPI Registry.