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DR. ROLAND SPURGEON BEVERLY III M.D.
NPI 1083687776
Dermatology in Aliso Viejo, CA

Active since February 11, 2006PECOS Enrolled
24541 PACIFIC PARK DR, SUITE 103, ALISO VIEJO, CA 92656(949) 831-3057(949) 831-2515 Get Directions Write a Review

NPPES record last updated: May 10, 2017. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Roland Spurgeon Beverly Iii M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. ROLAND SPURGEON BEVERLY III M.D. (NPI 1083687776) is an individual dermatology provider in Aliso Viejo, California, licensed in California (G65658) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1083687776
Entity TypeIndividualMale
Primary Taxonomy207N00000X
Provider Legal NameDR. ROLAND SPURGEON BEVERLY IIICredential: M.D.
Location Address24541 PACIFIC PARK DR, SUITE 103Aliso Viejo, CA 92656-3065
Mailing Address24541 Pacific Park Dr, Suite 103Aliso Viejo, CA 92656-3065 · (949) 831-3057 · Fax (949) 831-2515
Phone(949) 831-3057
Fax(949) 831-2515
Sole ProprietorNo
Enumeration DateFebruary 11, 2006
Last NPPES UpdateMay 10, 2017
✔ NPI 1083687776 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in CA · G65658
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
Also ListedDermatology · MOHS-Micrographic SurgeryTaxonomy 207ND0101X · License G65658 (CA)
24541 PACIFIC PARK DR, Aliso Viejo, CA 92656
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Other Identifiers 1

Medicare UPINE83457CA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Roland Spurgeon Beverly Iii M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Roland Beverly reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

J Robert West, M.D., Inc
10 mi
Dermatology
400 NEWPORT CENTER DR STE 702
Newport Beach, CA 92660
  • Reassigned Medicare billing, California enrollment
  • Medicare enrollment name: J Robert West MD Inc
  • 121 clinicians in this Medicare group
NPI 1932154788 (949) 644-0101

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92656 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$77.96 typical visit price
range $20.84 – $153.61
Typical copayment $19.49 (range $5.21 – $38.40)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 17

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SU-MIN WANG D.D.S.
Dentist (Pediatric Dentistry)
24541 PACIFIC PARK DR, SUITE 104
ALISO VIEJO, CA 92656
Orange County (949) 362-9860
DR. CIMA MAZAR-ATABAKI D.M.D.
Dentist (Pediatric Dentistry)
24541 PACIFIC PARK DR, SUITE 104
ALISO VIEJO, CA 92656
Orange County (949) 362-9860
BEVERLY DERMATOLOGY AND LASER CENTER
Dermatology
24541 PACIFIC PARK DR, SUITE 103
ALISO VIEJO, CA 92656
Orange County (909) 335-8638
DR. ERNEST BORIS ROBINSON M.D.
Plastic Surgery (Plastic Surgery Within the Head and Neck)
24541 PACIFIC PARK DR, SUITE #103
ALISO VIEJO, CA 92656
Orange County (949) 831-5900
MRS. ALISA WANG PA-C
Physician Assistant
24541 PACIFIC PARK DR
ALISO VIEJO, CA 92656
Orange County (949) 831-3057
DR. RICHARD CASO M.D.
Internal Medicine (Interventional Cardiology)
24541 PACIFIC PARK DR, #109
ALISO VIEJO, CA 92656
Orange County (949) 362-1212
DR. DANIEL E HASPERT M.D.
Specialist
24541 PACIFIC PARK DR, 109
ALISO VIEJO, CA 92656
Orange County (949) 362-1212
CIMA MAZAR-ATABAKI DMD INC
Dentist (Pediatric Dentistry)
24541 PACIFIC PARK DR, SUITE #104
ALISO VIEJO, CA 92656
Orange County (310) 985-0418

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Roland Beverly's NPI number?

The NPI number for Roland Beverly is 1083687776. It was assigned to this individual provider in the NPPES registry on February 11, 2006.

Where is Roland Beverly located?

Roland Beverly practices at 24541 Pacific Park Dr Suite 103, Aliso Viejo, CA 92656. The listed phone number is (949) 831-3057.

What is Roland Beverly's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Is Roland Beverly enrolled in Medicare?

Yes. Roland Beverly is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Roland Beverly's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Roland Beverly reassigns Medicare benefits to J Robert West, M.D., Inc (Newport Beach, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Roland Beverly's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Roland Beverly was last updated on May 10, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.