Individual provider Active NPI

Oscar I Rojas, M.D.

  • Pediatric Adolescent Medicine Physician
  • Nogales, AZ
National Provider Identifier
1447242300
Registry record updated Jun 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
18641 Issued in AZ
Practice address
1209 W Target Range Rd
Suite 103
Nogales, AZ 85621-2466
Phone
(520) 287-4656
Fax
(520) 287-2444
NPI assigned
Aug 17, 2005
Reactivated
Mar 29, 2006
Last updated
Jun 26, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X 18641 AZ Primary

Addresses

Primary practice location

1209 W Target Range Rd
Suite 103
Nogales, AZ 85621-2466

Mailing address

1209 W Target Range Rd
Suite 103
Nogales, AZ 85621-2466
Phone (520) 287-4656

Other identifiers 1

IdentifierTypeStateIssuer
287004001MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
18641AZMDPediatric Adolescent Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372204800000",
    "number": "1447242300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1209 W TARGET RANGE RD",
            "address_2": "SUITE 103",
            "city": "NOGALES",
            "state": "AZ",
            "postal_code": "856212466",
            "telephone_number": "520-287-4656",
            "fax_number": "520-287-2444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 W TARGET RANGE RD",
            "address_2": "SUITE 103",
            "city": "NOGALES",
            "state": "AZ",
            "postal_code": "856212466",
            "telephone_number": "520-287-4656",
            "fax_number": "520-287-2444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROJAS",
        "first_name": "OSCAR",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-17",
        "last_updated": "2013-06-26",
        "deactivation_date": "2006-03-23",
        "reactivation_date": "2006-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "AZ",
            "license": "18641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "287004001",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nogales, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2013; 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.