Individual provider Active NPI

Afra M Roet, P.A.

  • Physician Assistant
  • National City, CA
National Provider Identifier
1962548263
Registry record updated Aug 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA11803 Issued in CA
Practice address
2743 Highland Ave
National City, CA 91950-7410
Phone
(619) 474-2284
Fax
(619) 474-3919
NPI assigned
Jan 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA11803 CA Primary

Addresses

Primary practice location

2743 Highland Ave
National City, CA 91950-7410

Mailing address

1250 Cleveland Ave
305
San Diego, CA 92103-7300
Phone (619) 300-1320

Other identifiers 1

IdentifierTypeStateIssuer
PA11803MedicaidCA

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA11803CAMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314576000000",
    "number": "1962548263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 CLEVELAND AVE",
            "address_2": "305",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921037300",
            "telephone_number": "619-300-1320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2743 HIGHLAND AVE",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919507410",
            "telephone_number": "619-474-2284",
            "fax_number": "619-474-3919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROET",
        "first_name": "AFRA",
        "middle_name": "M",
        "name_prefix": "Miss",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2011-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA11803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA11803",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in National City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2011; 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.