Individual provider Active NPI

Aviva Tziporah Rogozen, PA-C

  • Physician Assistant
  • Houston, TX
National Provider Identifier
1437769833
Registry record updated Jul 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
4550 N Braeswood Blvd Apt 331
Houston, TX 77096-2883
Phone
(216) 401-9574
NPI assigned
Jul 31, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 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 Primary

Addresses

Primary practice location

4550 N Braeswood Blvd Apt 331
Houston, TX 77096-2883

Mailing address

4550 N Braeswood Blvd Apt 331
Houston, TX 77096-2883
Phone (216) 401-9574

Other identifiers 1

IdentifierTypeStateIssuer
PA13409OtherTXPHYSICIAN ASSISTANT LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20251002002554 TX Practitioner - Physician Assistant 0446756068 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1102 Bates Ave
Houston, TX 77030-2698

PO Box
Dallas, TX 75284

National Provider Directory

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

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": "1596153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596153600000",
    "number": "1437769833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4550 N BRAESWOOD BLVD APT 331",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770962883",
            "telephone_number": "216-401-9574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 N BRAESWOOD BLVD APT 331",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770962883",
            "telephone_number": "216-401-9574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGOZEN",
        "first_name": "AVIVA",
        "middle_name": "TZIPORAH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-31",
        "last_updated": "2020-07-31",
        "certification_date": "2020-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASSISTANT LICENSE",
            "identifier": "PA13409",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.