SEAN K ROH MD
NPI 1104568922
Student in an Organized Health Care Education/Training Program in Fontana, CA
About Sean K Roh Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SEAN K ROH MD (NPI 1104568922) is an individual student in an organized health care education/training program in Fontana, California and active in the NPI registry since April 2022. He is enrolled in Medicare PECOS and is a graduate of Cooper Medical School Of Rowan University (2022).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Sean K Roh Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Sean Roh reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Fontana, CA 92335
- Reassigned Medicare billing, California enrollment
- Also billed through NPI 1952333460 (California)
- 5,228 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
FONTANA, CA 92335
FONTANA, CA 92335
FONTANA, CA 92335
FONTANA, CA 92335
FONTANA, CA 92335
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 Sean Roh's NPI number?
The NPI number for Sean Roh is 1104568922. It was assigned to this individual provider in the NPPES registry on April 12, 2022.
Where is Sean Roh located?
Sean Roh practices at 17234 Valley Blvd Bldg. A, Fontana, CA 92335. The listed phone number is (909) 427-2608.
What is Sean Roh's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Sean Roh enrolled in Medicare?
Yes. Sean Roh is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Sean Roh's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Sean Roh reassigns Medicare benefits to Southern California Permanente Medical Group (Fontana, 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 Sean Roh'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 Sean Roh was last updated on July 27, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Sean K Roh, MD · NPI 1104568922
Student in an Organized Health Care Education/Training Program provider in Fontana, California. Individual provider, active in the CMS NPPES registry since April 12, 2022.
## Identity
- **NPI:** 1104568922 (Entity type: Individual)
- **Enumerated:** April 12, 2022
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** No
## Practice location
- **Address:** 17234 VALLEY BLVD, BLDG. A, Fontana, CA 92335
- **Phone:** (909) 427-2608
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Southern California Permanente Medical Group (NPI 1689606196, Fontana, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Cooper Medical School Of Rowan University, class of 2022
## Record status
- **NPPES last updated:** July 27, 2022
---
Source: [NPI Profile](https://npiprofile.com/npi/1104568922) · Data from the CMS NPPES public registry.