Individual provider Active NPI

Jim Shamblin Rosell, PA-C

  • Medical Physician Assistant
  • Rancho Mirage, CA
National Provider Identifier
1508256751
Registry record updated Apr 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
52253 Issued in CA
Practice address
39000 Bob Hope Dr, Harry & Diane Rinker Building
Rancho Mirage, CA 92270-3221
Phone
(760) 568-2684
Fax
(760) 341-5832
NPI assigned
Jan 27, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 52253 CA
Medical Physician Assistant 363AM0700X 52253 CA Primary

Addresses

Primary practice location

39000 Bob Hope Dr, Harry & Diane Rinker Building
Rancho Mirage, CA 92270-3221

Mailing address

39000 Bob Hope Dr, Harry & Diane Rinker Building
Rancho Mirage, CA 92270-3221
Phone (760) 568-2684

Other practice location 1

45280 Seeley Dr., FL 2
La Quinta, CA 92253-6834
Phone (760) 568-2684

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jrosell43662@edirect.emc.org Health Information Exchange (HIE)

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150325002311 CA Practitioner - Physician Assistant 6608193990 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Desert Orthopedic Center a Medical Group IncGroup PAC ID 2466346739, 49 clinicians

Practice addresses (Care Compare)

39000 Bob Hope Dr
Rancho Mirage, CA 92270-3221
Phone (760) 568-2684

Hospital & facility affiliations

  • Eisenhower Medical Center Hospital, Rancho Mirage, CA, CCN 050573

Merit-based Incentive Payment System (MIPS)

Final score
82.54 of 100Reported as group
Quality
77.5
Promoting interoperability
99
Improvement activities
40
Cost
65.14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
52253CAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Desert Orthopedic Center a Medical Group Inc Medical CurrentSince Feb 26, 2015 Accepting new patients
JFK Memorial Hospital, Inc. Past Accepting new patients

Locations

45280 Seeley Dr
Fl 2
La Quinta, CA 92253
Phone (760) 834-7920

39700 Bob Hope Dr
Ste 310
Rancho Mirage, CA 92270

39000 Bob Hope Dr
Rancho Mirage, CA 92270
Phone (760) 340-3911

Organizations & group practices 2

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 1

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": "1422316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1508256751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39000 BOB HOPE DR, HARRY & DIANE RINKER BUILDING",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922703221",
            "telephone_number": "760-568-2684",
            "fax_number": "760-341-5832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39000 BOB HOPE DR, HARRY & DIANE RINKER BUILDING",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922703221",
            "telephone_number": "760-568-2684",
            "fax_number": "760-341-5832"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "45280 Seeley Dr., FL 2",
            "address_purpose": "LOCATION",
            "city": "La Quinta",
            "state": "CA",
            "postal_code": "922536834",
            "country_code": "US",
            "telephone_number": "760-568-2684",
            "fax_number": "760-341-5832",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSELL",
        "first_name": "JIM",
        "middle_name": "SHAMBLIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-27",
        "last_updated": "2023-04-05",
        "certification_date": "2023-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "52253",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "52253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jrosell43662@edirect.emc.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "39000 Bob Hope Dr",
            "address_2": "Harry & Diane Rinker Building",
            "city": "Rancho Mirage",
            "state": "CA",
            "country_code": "US",
            "postal_code": "922703221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rancho Mirage, CA

Sources for this page

Verify at the official NPI Registry.