Roseville Dermatology Inc.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

ROSEVILLE DERMATOLOGY INC.

Practice address

1211 Pleasant Grove Blvd
Suite 100
Roseville, CA 95678-6971

Phone

(916) 784-7546

Fax

(916) 784-7548

NPI assigned

Jun 1, 2006

Organization subpart

No

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

Authorized official

Name

Christopher H Ha, M.D.NPI 1194764738

Title

President

Phone

(916) 784-7546

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IJDBBA

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Christopher H Ha, M.D.

  • Dermatology Physician
  • Roseville, CA
  • NPI 1194764738
  Medicare reassignment Care Compare group NPD Authorized official
• Supinder Kaur Randhawa, NP

  • Nurse Practitioner
  • Roseville, CA
  • NPI 1821474230
  Medicare reassignment Care Compare group NPD
• Shannon Rae Sgro, P.A.-C

  • Physician Assistant
  • Roseville, CA
  • NPI 1396790358
  Medicare reassignment Care Compare group NPD
• Babu Singh, M.D.

  • Dermatology Physician
  • Roseville, CA
  • NPI 1407293665
  Medicare reassignment Care Compare group NPD
• Michael Eugeniuscz Froniewski, PA-C

  • Physician Assistant
  • Roseville, CA
  • NPI 1093287161
  Medicare reassignment Care Compare group
• David Shane Hagemann, PA

  • Physician Assistant
  • Roseville, CA
  • NPI 1881675619
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194566400000",
    "number": "1508803263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 PLEASANT GROVE BLVD",
            "address_2": "SUITE 100",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956786971",
            "telephone_number": "916-784-7546",
            "fax_number": "916-784-7548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 PLEASANT GROVE BLVD",
            "address_2": "SUITE 100",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956786971",
            "telephone_number": "916-784-7546",
            "fax_number": "916-784-7548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSEVILLE DERMATOLOGY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2007-11-09",
        "status": "A",
        "authorized_official_last_name": "HA",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "916-784-7546",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PIN",
            "identifier": "00A604281",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PIN",
            "identifier": "1898591",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Spencer Daniel Rosenberg, PH.D.
• Roseville Cardiology Medical Associates, Inc.
• Roseville Care Center, Inc.
• Roseville Center for Interventional Psychiatry, Inc
• Roseville City Elementary
• Roseville Diagnostic Hearing Center, Inc.
• Roseville Diagnostic Hearing Center, LLC
• Roseville Endoscopy Center, LLC
• Roseville Family Urgent Care Inc
• Roseville Foot and Ankle PC

• Dermatology Physician in Roseville, CA
• Providers in Roseville, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.