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DR. OVICTOR LEO ROLDAN TESORO M.D.
NPI 1356584759
Psychiatry & Neurology - Neurology with Special Qualifications in Child Neurology in Phoenix, AZ

Active since April 14, 2009PECOS Enrolled
2601 E ROOSEVELT ST, PHOENIX, AZ 85008(602) 344-5011 Get Directions Write a Review

NPPES record last updated: March 9, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Ovictor Leo Roldan Tesoro M.d. NPPES

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

DR. OVICTOR LEO ROLDAN TESORO M.D. (NPI 1356584759) is an individual neurology with special qualifications in child neurology provider in Phoenix, Arizona, licensed in Arizona (47955) and active in the NPI registry since April 2009. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1356584759
Entity TypeIndividualMale
Primary Taxonomy2084N0402X
Provider Legal NameDR. OVICTOR LEO ROLDAN TESOROCredential: M.D.
Location Address2601 E ROOSEVELT STPhoenix, AZ 85008-4973
Mailing Address4301 N 21st StPhoenix, AZ 85016-5552 · (602) 344-1691
Phone(602) 344-5011
Sole ProprietorYes
Enumeration DateApril 14, 2009
Last NPPES UpdateMarch 9, 2015
✔ NPI 1356584759 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · Neurology with Special Qualifications in Child NeurologyAllopathic & Osteopathic Physicians
Taxonomy Code2084N0402X
License✔ Licensed in AZ · 47955
Definition
A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence.
2601 E ROOSEVELT ST, Phoenix, AZ 85008
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter from Sunflower Health Plan, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Ovictor Leo Roldan Tesoro 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85008 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
$127.71 typical visit price
range $55.44 – $168.60
Typical copayment $31.92 (range $13.86 – $42.15)
Most-billed visit code 99204
Established Patient
$98.00 typical visit price
range $17.72 – $137.41
Typical copayment $24.50 (range $4.43 – $34.35)
Most-billed visit code 99214
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 20

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

DR. JOEL PHILIP BETZ M.D.
Emergency Medicine (Emergency Medical Services)
2601 E ROOSEVELT ST
PHOENIX, AZ 85008
Maricopa County (602) 344-5411
DR. ALI SHAHEEN AL-YAQOOBI M.D.
Internal Medicine
2601 E ROOSEVELT ST
PHOENIX, AZ 85008
Maricopa County (602) 344-5411
MARICOPA INTEGRATED HEALTH SYSTEM
General Acute Care Hospital
2601 E ROOSEVELT ST, DEPARTMENT OF MEDICINE
PHOENIX, AZ 85008
Maricopa County (602) 344-5366
OWEN THOMAS MCCABE MD
Surgery (Trauma Surgery)
2601 E ROOSEVELT ST
PHOENIX, AZ 85008
Maricopa County (602) 344-5011
BRIGHAM NICOLL
Psychiatry & Neurology (Psychiatry)
2601 E ROOSEVELT ST
PHOENIX, AZ 85008
Maricopa County (602) 344-5011
DR. AMELIA CATHERINE VAN HANDEL M.D.
Plastic Surgery
2601 E ROOSEVELT ST
PHOENIX, AZ 85008
Maricopa County (410) 999-0858
KEVIN YANG
Psychiatry & Neurology (Psychiatry)
2601 E ROOSEVELT ST
PHOENIX, AZ 85008
Maricopa County (602) 344-5011
STEPHANIE BERKSHIRE DO
Internal Medicine
2601 E ROOSEVELT ST
PHOENIX, AZ 85008
Maricopa County (602) 344-5892

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 Ovictor Leo Tesoro's NPI number?

The NPI number for Ovictor Leo Tesoro is 1356584759. It was assigned to this individual provider in the NPPES registry on April 14, 2009.

Where is Ovictor Leo Tesoro located?

Ovictor Leo Tesoro practices at 2601 E Roosevelt St, Phoenix, AZ 85008. The listed phone number is (602) 344-5011.

What is Ovictor Leo Tesoro's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology with Special Qualifications in Child Neurology, with taxonomy code 2084N0402X.

Is Ovictor Leo Tesoro enrolled in Medicare?

Yes. Ovictor Leo Tesoro is registered in the Medicare PECOS enrollment system.

What insurance does Ovictor Leo Tesoro accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and Avera Health Plans and 1 other insurer list Ovictor Leo Tesoro as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Ovictor Leo Tesoro was last updated on March 9, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.