NPIMap

Individual provider Active NPI

Roumta Ashor Odisho, MD

  • Obstetrics & Gynecology Physician
  • La Mesa, CA
National Provider Identifier
1467956276
Registry record updated Jun 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A179837 Issued in CA
Practice address
8860 Center Dr Ste 360
La Mesa, CA 91942-7003
Phone
(619) 403-5700
NPI assigned
Mar 19, 2018
Last updated
Jun 24, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Obstetrics & Gynecology Physician 207V00000X A179837 CA Primary

Addresses

Primary practice location

8860 Center Dr Ste 360
La Mesa, CA 91942-7003

Mailing address

8860 Center Dr Ste 360
La Mesa, CA 91942-7003
Phone (619) 403-5700

Other practice location 1

500 Rue De La Vie St Ste 404
Baton Rouge, LA 70817-5128
Phone (225) 215-7442

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
I20220818000852 CA Practitioner - Obstetrics/Gynecology 5698022796 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Louisiana State University School of Medicine in New Orleans, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Coast OB/GYN, Inc.Group PAC ID 1850315235, 15 clinicians

Practice addresses (Care Compare)

7695 Cardinal CT
Suite 240
San Diego, CA 92123-3357
Phone (858) 277-9378

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A179837CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Obhg California, P.C. Obstetrics & Gynecology CurrentSince Sep 1, 2025 Accepting new patients
Obstetrics & Gynecology Surgical Associates Obstetrics & Gynecology PastSince Jun 26, 2022 Accepting new patients
Grossmont Hospital Corporation Past Accepting new patients

Locations

5555 Grossmont Center Dr
La Mesa, CA 91942
Phone (619) 465-0711

Interoperability endpoints

  • Direct secure messaging: rodisho32455@sharphealthcare.direct-ci.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1521417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656028800000",
    "number": "1467956276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8860 CENTER DR STE 360",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919427003",
            "telephone_number": "619-403-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8860 CENTER DR STE 360",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919427003",
            "telephone_number": "619-403-5700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Rue De La Vie St Ste 404",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708175128",
            "country_code": "US",
            "telephone_number": "225-215-7442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ODISHO",
        "first_name": "ROUMTA",
        "middle_name": "ASHOR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-19",
        "last_updated": "2022-06-24",
        "certification_date": "2022-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A179837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

Verify at the official NPI Registry.