Organization Active NPI

Richmond E Roeske a Professional Corp

  • Ophthalmology Physician
  • Temecula, CA
National Provider Identifier
1689776569
Registry record updated Sep 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
A64048 Issued in CA
Legal business name
RICHMOND E ROESKE A PROFESSIONAL CORP
Practice address
41877 Enterprise Cir N
Ste 110
Temecula, CA 92590-5656
Phone
(951) 296-2244
Fax
(951) 296-3602
NPI assigned
Sep 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2012

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

Authorized official

Name
Richmond E Roeske, MD
Title
Pres
Phone
(951) 296-2244

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X A64048 CA Primary

Addresses

Primary practice location

41877 Enterprise Cir N
Ste 110
Temecula, CA 92590-5656

Mailing address

41877 Enterprise Cir N
Ste 110
Temecula, CA 92590-5656
Phone (951) 296-2244

Other identifiers 2

IdentifierTypeStateIssuer
00A640480MedicaidCA
DD5158OtherCARAILROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

41877 Enterprise Cir N
Temecula, CA 92590
Phone (951) 290-2785

41540 Winchester Rd
Ste B
Temecula, CA 92590
Phone (909) 296-1822

41877 Enterprise Cir N
Ste 110
Temecula, CA 92590
Phone (951) 296-2244

Practitioners & affiliated clinicians

Practitioners 5

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": "1157155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348099200000",
    "number": "1689776569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41877 ENTERPRISE CIR N",
            "address_2": "STE 110",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925905656",
            "telephone_number": "951-296-2244",
            "fax_number": "951-296-3602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41877 ENTERPRISE CIR N",
            "address_2": "STE 110",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925905656",
            "telephone_number": "951-296-2244",
            "fax_number": "951-296-3602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHMOND E ROESKE A PROFESSIONAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-02",
        "last_updated": "2012-09-20",
        "status": "A",
        "authorized_official_last_name": "ROESKE",
        "authorized_official_first_name": "RICHMOND",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "951-296-2244",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A64048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A640480",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DD5158",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Temecula, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.