Individual provider Active NPI

Jennifer Sueyun Roh, M.D.

  • Emergency Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1639517675
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A149256 Issued in CA
Practice address
757 Westwood PLZ Ste 1517
Los Angeles, CA 90095-3220
Phone
(310) 825-2111
NPI assigned
Jun 12, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 56235 CT
Emergency Medicine Physician 207P00000X A149256 CA Primary

Addresses

Primary practice location

757 Westwood PLZ Ste 1517
Los Angeles, CA 90095-3220

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631
Phone (203) 688-4242

Other practice location 1

20 York St
T-209
New Haven, CT 06510-3220
Phone (203) 688-4242

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170623001840 CA Practitioner - Emergency Medicine 0446571319 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A149256CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Emergency Medicine CurrentSince Jul 1, 2018 Accepting new patients
Pacifica Emergency Medical Associates Emergency Medicine CurrentSince May 15, 2018 Accepting new patients
Seven Star Hospital Associates Inc. CurrentSince Jan 27, 2023 Accepting new patients
University of California Irvine Past Accepting new patients
UCLA Medical Group Emergency Medicine Past Accepting new patients

Locations

1117 E Devonshire Ave
Hemet, CA 92543
Phone (951) 652-2811

101 The City Dr S
Bldg 1
Orange, CA 92868
Phone (714) 456-2911

2601 E Chapman Ave
Orange, CA 92869
Phone (714) 633-0011

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

28400 McCall Blvd
Sun City, CA 92585
Phone (909) 679-8888

16237 Ventura Blvd
Van Nuys, CA 91436
Phone (818) 995-5000

15248 Eleventh St
Victorville, CA 92395
Phone (760) 245-8691

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1370995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1639517675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631",
            "telephone_number": "203-688-4242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "757 WESTWOOD PLZ STE 1517",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900953220",
            "telephone_number": "310-825-2111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 York St",
            "address_2": "T-209",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065103220",
            "country_code": "US",
            "telephone_number": "203-688-4242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROH",
        "first_name": "JENNIFER",
        "middle_name": "SUEYUN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-12",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CT",
            "license": "56235",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A149256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.