Organization Active NPI

Rokay Kamyar, M.D. Inc.

  • Multi-Specialty Clinic/Center
  • La Mesa, CA
National Provider Identifier
1528057957
Registry record updated Jan 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
ROKAY KAMYAR, M.D. INC.
Practice address
5119 Garfield St
La Mesa, CA 91941-5103
Phone
(619) 460-4055
Fax
(619) 460-5148
NPI assigned
Oct 18, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2011

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

Authorized official

Name
Mrs. Katherine Hendrickson
Title
Office Manager
Phone
(619) 460-4055

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

5119 Garfield St
La Mesa, CA 91941-5103

Mailing address

5119 Garfield St
La Mesa, CA 91941-5103
Phone (619) 460-4055

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050630001091 CA Part B Supplier - Clinic/Group Practice 0244276194 Receives reassigned benefits from 1 practitioner
Practice locations: La Mesa, CA

National Provider Directory

National Provider Directory

Locations

5119 Garfield St
La Mesa, CA 91941
Phone (619) 460-4055

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294272000000",
    "number": "1528057957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5119 GARFIELD ST",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919415103",
            "telephone_number": "619-460-4055",
            "fax_number": "619-460-5148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5119 GARFIELD ST",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919415103",
            "telephone_number": "619-460-4055",
            "fax_number": "619-460-5148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROKAY KAMYAR, M.D. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-18",
        "last_updated": "2011-01-06",
        "status": "A",
        "authorized_official_last_name": "HENDRICKSON",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "619-460-4055",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2011; 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.