Active NPI
Pharez Dishon Rolle
- Psychiatry Physician
- Loma Linda, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- A143415
- Practice address
- 11234 Anderson St
Loma Linda University Medical Center Psychiatry
Loma Linda, CA 92354 - Phone
- (909) 558-9532
- NPI assigned
- May 13, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | A143415 | CA | Primary |
Addresses
Primary practice location
11234 Anderson St
Loma Linda University Medical Center Psychiatry
Loma Linda, CA 92354
Mailing address
11234 Anderson St
Westerly BLDG-Suite C
Loma Linda, CA 92354-2804
Phone (909) 558-4174
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Loma Linda University School of Medicine, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1686 Barton Rd
Redlands, CA 92373-1488
Phone (909) 558-9551
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.87 of 100
- Quality
- 72.13
- Promoting interoperability
- 80
- Improvement activities
- 40
- Cost
- 77.36
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Faculty Physicians and Surgeons of Llusm | Current | Accepting new patients | |
| Faculty Physicians and Surgeons of Llusm | Current | Accepting new patients | |
| Faculty Physicians and Surgeons of Llusm | Psychiatry | Current | Accepting new patients |
| Sac Health System | Current | Accepting new patients | |
| Sac Health System | Current | Accepting new patients | |
| Sac Health System | Current | Accepting new patients | |
| Faculty Physicians and Surgeons of Llusm | Past | Accepting new patients | |
| Faculty Physicians and Surgeons of Llusm | Past | Accepting new patients |
Locations
11234 Anderson St
Loma Linda, CA 92350
Phone (909) 558-3016
11234 Anderson St
#C
Loma Linda, CA 92350
Phone (909) 558-4074
File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300
1686 Barton Rd
#2100
Redlands, CA 92373
1686 Barton Rd
Redlands, CA 92373
Phone (909) 558-9200
250 S G St
San Bernardino, CA 92410
Phone (909) 771-2990
1455 3rd Ave
Sn Bernrdno, CA 92408
Phone (909) 382-7146
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- prolle24384@direct.llu.edu
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.
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Apple Valley, CA
- NPI 1205009917
-
- Federally Qualified Health Center (FQHC)
- San Bernardino, CA
- NPI 1013935923
-
- Psychiatry Physician
- Redlands, CA
- NPI 1558311373
-
- Family Medicine Physician
- Moreno Valley, CA
- NPI 1558788331
-
- Federally Qualified Health Center (FQHC)
- San Bernardino, CA
- NPI 1467274126
-
- Federally Qualified Health Center (FQHC)
- San Bernardino, CA
- NPI 1801270137
-
- Orthopaedic Surgery Physician
- Loma Linda, CA
- NPI 1275582918
-
- Neurological Surgery Physician
- Loma Linda, CA
- NPI 1528018553
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1399939200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529971200000",
"number": "1477964427",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11234 ANDERSON ST",
"address_2": "WESTERLY BLDG-SUITE C",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923542804",
"telephone_number": "909-558-4174"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11234 ANDERSON ST",
"address_2": "LOMA LINDA UNIVERSITY MEDICAL CENTER PSYCHIATRY",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "92354",
"telephone_number": "909-558-9532"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROLLE",
"first_name": "PHAREZ",
"middle_name": "DISHON",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-05-13",
"last_updated": "2018-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A143415",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Loma Linda, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.