Active NPI
Benjamin Roos, PSYD
- Psychologist
- Pasadena, CA
National Provider Identifier
1538710207
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 33538
- Practice address
- 595 E Colorado Blvd Ste 610
Pasadena, CA 91101-2015 - Phone
- (626) 344-0232
- NPI assigned
- Sep 24, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 11421644-2504 | UT | |
| Psychologist | 103T00000X | 33538 | CA | Primary |
Addresses
Primary practice location
595 E Colorado Blvd Ste 610
Pasadena, CA 91101-2015
Mailing address
141 San Pascual Ave Apt 3
Los Angeles, CA 90042-3763
Phone (626) 344-0232
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2025 through Jan 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11421644-2504 | UT | MD | Psychologist |
| 33538 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569283200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661212800000",
"number": "1538710207",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "141 SAN PASCUAL AVE APT 3",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900423763",
"telephone_number": "626-344-0232"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "595 E COLORADO BLVD STE 610",
"city": "PASADENA",
"state": "CA",
"postal_code": "911012015",
"telephone_number": "626-344-0232"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROOS",
"first_name": "BENJAMIN",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-09-24",
"last_updated": "2022-08-23",
"certification_date": "2022-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "UT",
"license": "11421644-2504",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "33538",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pasadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.