Organization Active NPI

Roc Medical

  • Internal Medicine Physician
  • Stockton, CA
National Provider Identifier
1891209359
Registry record updated Oct 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A93056 Issued in CA
Legal business name
ROC MEDICAL
Practice address
1805 N California St Ste 406
Stockton, CA 95204-6033
Phone
(209) 227-7806
Fax
(209) 851-3853
NPI assigned
Nov 20, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2018

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

Authorized official

Name
Dr. Richard O Camacho, M.D.NPI 1649253881
Title
Owner
Phone
(209) 227-7806

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X A93056 CA Primary
Primary Care Clinic/Center 261QP2300X A93056 CA

Addresses

Primary practice location

1805 N California St Ste 406
Stockton, CA 95204-6033

Mailing address

1805 N California St Ste 406
Stockton, CA 95204-6033
Phone (209) 227-7806

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180530001901 CA Part B Supplier - Clinic/Group Practice 0547525248 Receives reassigned benefits from 3 practitioners
Practice locations: Stockton, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2152811Roc Medical1805 N California Street Suite 406, Stockton, CA 95204Certificate of waiverAug 16, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1511136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540684800000",
    "number": "1891209359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 N CALIFORNIA ST STE 406",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046033",
            "telephone_number": "209-227-7806",
            "fax_number": "209-851-3853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 N CALIFORNIA ST STE 406",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046033",
            "telephone_number": "209-227-7806",
            "fax_number": "209-851-3853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROC MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-20",
        "last_updated": "2018-10-28",
        "status": "A",
        "authorized_official_last_name": "CAMACHO",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "209-227-7806",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A93056",
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "A93056",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.