Derek Rogoz

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

59384 Issued in CA

Practice address

301 N Prairie Ave Ste 202
Inglewood, CA 90301-4509

Phone

(323) 480-4075

NPI assigned

Apr 16, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1618531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675814400000",
    "number": "1336720804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 N PRAIRIE AVE STE 202",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903014509",
            "telephone_number": "323-480-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N PRAIRIE AVE STE 202",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903014509",
            "telephone_number": "323-480-4075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGOZ",
        "first_name": "DEREK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-16",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "59384",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1992306872",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1043410871",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1598273328",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Luis Rodriguez, MS
• Maria Teresa Rodriguez, R1379850320
• Rodrigo Alejandro Rodriguez
• Tania C Rodriguez
• Victoria Marie Rodriguez
• Kira Rohrer, PA-C
• Diana Stefanie Rojas Torres, M.D.
• Roman a. Litwinski, M.D., Inc
• Lizbeth Romero, BS GENERALSOCIOLOGY
• Ronald Seymour Weaver MD Inc.

• Physician Assistant in Inglewood, CA
• Providers in Inglewood, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.