Jedd Lyn Ticar Roessner, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A159778 Issued in CA

Practice address

303 Loma Dr Ste 202
Los Angeles, CA 90017-1103

Phone

(213) 858-5126

Fax

(213) 858-5154

NPI assigned

Mar 23, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1458691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1760844310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 S GRAND AVE FL 2",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900153999",
            "telephone_number": "323-669-4346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 LOMA DR STE 202",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900171103",
            "telephone_number": "213-858-5126",
            "fax_number": "213-858-5154"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4618 Fountain Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900291977",
            "country_code": "US",
            "telephone_number": "323-953-7170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROESSNER",
        "first_name": "JEDD LYN",
        "middle_name": "TICAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-23",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A159778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David James Lummen Roedema
• Fiona Margarete Sophia Roediger, MD
• Arthur Roehr, DNP, PMHNP-BC
• Kelsey Andrea Roelofs, MD
• Robin Roemer
• Marian T Rofail, PHARM.D
• Peter John Roffey, M.D.
• Jeanette Rogan, RN
• George P Rogasch
• Julie Anne Rogawski, MD

• Pediatrics Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2021; 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.