Active NPI
Roger Steve Phillips, M.D.
- Anatomic Pathology & Clinical Pathology Physician
- Merced, CA
National Provider Identifier
1982696431
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- A35984
- Practice address
- 625 W Olive Ave
Suite 310
Merced, CA 95348-2419 - Phone
- (209) 723-4551
- Fax
- (209) 723-0141
- NPI assigned
- Aug 19, 2005
- Last updated
- Aug 10, 2009
- 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 |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | A35984 | CA | Primary |
Addresses
Primary practice location
625 W Olive Ave
Suite 310
Merced, CA 95348-2419
Mailing address
625 W Olive Ave
Suite 310
Merced, CA 95348-2419
Phone (209) 723-4551
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LAB44024F | Medicaid | CA | |
| 942553560 | Other | CA | TAX IDENTIFICATION NUMBER |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Yosemite Pathology Medical Group, in | Past | Accepting new patients | |
| Diagnostic Pathology Medical Group, Inc. | Anatomic Pathology & Clinical Pathology | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinical Medical Laboratory
- Tracy, CA
- NPI 1114192176
-
- Anatomic Pathology & Clinical Pathology Physician
- Carson City, NV
- NPI 1417636093
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1249862400000",
"number": "1982696431",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "625 W OLIVE AVE",
"address_2": "SUITE 310",
"city": "MERCED",
"state": "CA",
"postal_code": "953482419",
"telephone_number": "209-723-4551",
"fax_number": "209-723-0141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "625 W OLIVE AVE",
"address_2": "SUITE 310",
"city": "MERCED",
"state": "CA",
"postal_code": "953482419",
"telephone_number": "209-723-4551",
"fax_number": "209-723-0141"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "ROGER",
"middle_name": "STEVE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-19",
"last_updated": "2009-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "CA",
"license": "A35984",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "LAB44024F",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX IDENTIFICATION NUMBER",
"identifier": "942553560",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Merced, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.