NPIMap

Individual provider Active NPI

Roshan Patel, M.D.

  • Rheumatology Physician
  • Covina, CA
National Provider Identifier
1457709131
Registry record updated Feb 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
A173087 Issued in CA
Practice address
500 W San Bernardino Rd Ste a
Covina, CA 91722-3797
Phone
(626) 966-1909
Fax
(626) 869-5732
NPI assigned
Jun 2, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 57247909 OH
Student in an Organized Health Care Education/Training Program 390200000X
Rheumatology Physician 207RR0500X A173087 CA Primary

Addresses

Primary practice location

500 W San Bernardino Rd Ste a
Covina, CA 91722-3797

Mailing address

PO Box 10069
San Bernardino, CA 92423-0069
Phone (909) 335-4188

Other practice location 1

7000 Boulder Ave
Highland, CA 92346-3348
Phone (909) 862-1191

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210923000933 CA Practitioner - Rheumatology 0547557522 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Ohio State University College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Samy Metyas M.D. IncGroup PAC ID 9830144534, 3 clinicians

Practice addresses (Care Compare)

500 W San Bernardino Rd
Suite a
Covina, CA 91722-3797
Phone (626) 966-1909

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A173087CAMDRheumatology Physician
57247909OHMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Samy Metyas, M.D., Inc. CurrentSince Dec 1, 2022 Accepting new patients
Beaver Medical Group P C Rheumatology CurrentSince Sep 20, 2021 Accepting new patients
Beaver Medical Group P C CurrentSince Sep 20, 2021 Accepting new patients
San Gorgonio Memorial Hospital Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Redlands Community Hospital Past Accepting new patients
Emanate Health Foothill Presbyterian Hospital Past Accepting new patients
Hemet Valley Medical Center Past Accepting new patients

Locations

500 W San Bernardino Rd
Ste A
Covina, CA 91722
Phone (626) 966-1909

7000 Boulder Ave
Highland, CA 92346

2 W Fern Ave
Redlands, CA 92373
Phone (909) 335-4137

2 W Fern Ave
#1112
Redlands, CA 92373

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 8

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1464825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676332800000",
    "number": "1457709131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10069",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924230069",
            "telephone_number": "909-335-4188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W SAN BERNARDINO RD STE A",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917223797",
            "telephone_number": "626-966-1909",
            "fax_number": "626-869-5732"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7000 Boulder Ave",
            "address_purpose": "LOCATION",
            "city": "Highland",
            "state": "CA",
            "postal_code": "923463348",
            "country_code": "US",
            "telephone_number": "909-862-1191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "ROSHAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-02",
        "last_updated": "2023-02-14",
        "certification_date": "2023-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "OH",
            "license": "57247909",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "CA",
            "license": "A173087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covina, CA

Sources for this page

Verify at the official NPI Registry.