Individual provider Active NPI

Roger Michael De Sesa, D.C.

  • Chiropractor
  • Valencia, CA
National Provider Identifier
1912023904
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC25850 Issued in CA
Practice address
27674 Newhall Ranch Rd
Suite #65
Valencia, CA 91355-4018
Phone
(661) 294-0429
Fax
(661) 294-0439
NPI assigned
Mar 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC25850 CA Primary

Addresses

Primary practice location

27674 Newhall Ranch Rd
Suite #65
Valencia, CA 91355-4018

Mailing address

27674 Newhall Ranch Rd
Suite #65
Valencia, CA 91355-4018
Phone (661) 294-0429

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100811000900 CA Practitioner - Chiropractic 3779642111 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1998
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

27674 Newhall Ranch Rd
Valencia, CA 91355-4020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC25850CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Carolyn Griffin - Back to Health Chiropractic Corporation Chiropractor CurrentSince Nov 18, 2020 Accepting new patients

Locations

27674 Newhall Ranch Rd
Unit 65
Valencia, CA 91355
Phone (661) 294-0429

Organizations & group practices 1

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": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912023904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27674 NEWHALL RANCH RD",
            "address_2": "SUITE #65",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913554018",
            "telephone_number": "661-294-0429",
            "fax_number": "661-294-0439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27674 NEWHALL RANCH RD",
            "address_2": "SUITE #65",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913554018",
            "telephone_number": "661-294-0429",
            "fax_number": "661-294-0439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE SESA",
        "first_name": "ROGER",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC25850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valencia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.