Active NPI
Roger Guy Nicosia, MD
- Anesthesiology Physician
- Riverside, CA
National Provider Identifier
1720121833
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- A32221
- Practice address
- 7160 Brockton Ave.
Riverside, CA 92506-3912 - Phone
- (951) 782-3801
- Fax
- (951) 328-9742
- NPI assigned
- Feb 15, 2007
- 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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | A32221 | CA | Primary |
Addresses
Primary practice location
7160 Brockton Ave.
Riverside, CA 92506-3912
Mailing address
3660 Arlington Ave
Riverside, CA 92506-3912
Phone (951) 782-5110
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A322210 | Medicaid | CA | |
| 1730180415 | Other | CA | GROUP NPI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32221 | CA | MD | Clinical Psychologist |
| A32221 | CA | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1293580800000",
"number": "1720121833",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3660 ARLINGTON AVE",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925063912",
"telephone_number": "951-782-5110",
"fax_number": "951-274-0403"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7160 BROCKTON AVE.",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925063912",
"telephone_number": "951-782-3801",
"fax_number": "951-328-9742"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICOSIA",
"first_name": "ROGER",
"middle_name": "GUY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-15",
"last_updated": "2010-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CA",
"license": "A32221",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A322210",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP NPI",
"identifier": "1730180415",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.