Active NPI
Roman Sapozhnikov, M.D.
- Internal Medicine Physician
- San Diego, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- C150369
- Practice address
- 1809 National Ave
San Diego, CA 92113-2113 - Phone
- (619) 515-2300
- NPI assigned
- Jun 24, 2010
- Last updated
- May 2, 2018
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | C150369 | CA | Primary |
Addresses
Primary practice location
1809 National Ave
San Diego, CA 92113-2113
Mailing address
823 Gateway Center Way
San Diego, CA 92102-4541
Phone (619) 906-4623
Other practice location 1
760 Broadway
Medicine Department
Brooklyn, NY 11206-5317
Phone (718) 963-5808
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C150369 | CA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Health Centers of San Diego Inc | Current | Accepting new patients | |
| Imperial Valley Family Care Medical Group Apc | Current | Accepting new patients | |
| Family Health Centers of San Diego, Inc | Current | Accepting new patients | |
| Family Health Centers of San Diego, Inc | Current | Accepting new patients | |
| Imperial Valley Family Care Medical Group, Apc | Current | Accepting new patients |
Locations
125 S 5th St
Brawley, CA 92227
Phone (760) 344-8100
516 W Aten Rd
Ste 2
Imperial, CA 92251
Phone (760) 355-7730
1809 National Ave
San Diego, CA 92113
Phone (619) 515-2500
823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Logan Heights Family Health Center
- Federally Qualified Health Center (FQHC)
- San Diego, CA
- NPI 1447281936
-
- General Practice Physician
- Imperial, CA
- NPI 1275581894
-
dba Beach Area Family Health Center Annex
- Federally Qualified Health Center (FQHC)
- San Diego, CA
- NPI 1184982159
-
dba Escondido Physical Health and Wellness
- Federally Qualified Health Center (FQHC)
- Escondido, CA
- NPI 1356178180
-
- Cardiac Rehabilitation Registered Nurse
- Imperial, CA
- NPI 1750112587
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277337600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525219200000",
"number": "1558672535",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "823 GATEWAY CENTER WAY",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921024541",
"telephone_number": "619-906-4623",
"fax_number": "619-906-4564"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1809 NATIONAL AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921132113",
"telephone_number": "619-515-2300"
}
],
"practiceLocations": [
{
"address_1": "760 Broadway",
"address_2": "Medicine Department",
"address_purpose": "LOCATION",
"city": "Brooklyn",
"state": "NY",
"postal_code": "112065317",
"country_code": "US",
"telephone_number": "718-963-5808",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SAPOZHNIKOV",
"first_name": "ROMAN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-06-24",
"last_updated": "2018-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "C150369",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.