NPIMap

Individual provider Active NPI

Roscoe Lyndon Marter, MD.

  • Obstetrics & Gynecology Physician
  • Valencia, CA
National Provider Identifier
1609891142
Registry record updated Oct 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
G76143 Issued in CA
Practice address
25775 McBean Pkwy
Valencia, CA 91355-3708
Phone
(661) 424-8848
Fax
(661) 424-8849
NPI assigned
Jul 13, 2006
Last updated
Oct 8, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X G76143 CA Primary

Addresses

Primary practice location

25775 McBean Pkwy
Valencia, CA 91355-3708

Mailing address

PO Box 9602
Mission Hills, CA 91346-9602
Phone (818) 837-5637

Other identifiers 1

IdentifierTypeStateIssuer
00G761430MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040317000938 CA Practitioner - Obstetrics/Gynecology 1456241017 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Loma Linda University School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

19950 Rinaldi St
Porter Ranch, CA 91326-4141
Phone (818) 403-2400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G76143CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Facey Medical Foundation Obstetrics & Gynecology CurrentSince May 1, 1999 Accepting new patients
Providence Facey Medical Foundation CurrentSince May 1, 1999 Accepting new patients
Providence Medical Institute Obstetrics & Gynecology PastSince Jun 5, 2019 Accepting new patients
Providence Health System - Southern California Past Accepting new patients
Henry Mayo Newhall Memorial Hospital Past Accepting new patients

Locations

File 50670
Los Angeles, CA 90074

18460 Roscoe Blvd
Northridge, CA 91325
Phone (818) 734-3600

19950 Rinaldi St
Ste 103
Porter Ranch, CA 91326
Phone (818) 403-2400

26357 McBean Pkwy
Ste 390
Santa Clarita, CA 91355
Phone (661) 222-2600

23803 McBean Pkwy
Ste 201
Valencia, CA 91355
Phone (661) 481-2400

23803 McBean Pkwy
Ste 202
Valencia, CA 91355
Phone (661) 481-2400

25775 McBean Pkwy
Valencia, CA 91355
Phone (661) 255-6802

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: rmarter350462@oc.providencedirect.org

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Henry Mayo Newhall Memorial HospitalValencia, CA, CCN 050624 Hospital Corporate Director Apr 4, 2011
Henry Mayo Newhall Memorial HospitalValencia, CA, CCN 05S624 Hospital Corporate Director Apr 4, 2011
Henry Mayo Newhall Memorial HospitalValencia, CA, CCN 05T624 Hospital Corporate Director Apr 4, 2011

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349654400000",
    "number": "1609891142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9602",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913469602",
            "telephone_number": "818-837-5637",
            "fax_number": "818-837-5589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25775 MCBEAN PKWY",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913553708",
            "telephone_number": "661-424-8848",
            "fax_number": "661-424-8849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTER",
        "first_name": "ROSCOE",
        "middle_name": "LYNDON",
        "credential": "MD.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2012-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "G76143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G761430",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valencia, CA

Sources for this page

Verify at the official NPI Registry.