ROOSEVELT CARE OF CALIFORNIA PC
NPI 1740056993
Psychologist - Clinical in Los Angeles, CA

Q: What is Roosevelt Care Of California PC's NPI number?

The NPI number for Roosevelt Care Of California PC is 1740056993. It was assigned to this organization in the NPPES registry on November 29, 2023.

Q: What is Roosevelt Care Of California PC's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Active since November 29, 2023

826 N MARIPOSA AVE, LOS ANGELES, CA 90029(848) 210-4422 Get Directions Write a Review

NPPES record last updated: November 29, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Roosevelt Care Of California Pc NPPES

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

ROOSEVELT CARE OF CALIFORNIA PC (NPI 1740056993) is a healthcare organization registered as a clinical in Los Angeles, California and active in the NPI registry since November 2023. The organization lists Dov Newmark, Ceo, as its authorized official.

NPPES Registry Identity

NPI1740056993

Entity TypeOrganization

Primary Taxonomy103TC0700X

Legal Business NameROOSEVELT CARE OF CALIFORNIA PC

Location Address826 N MARIPOSA AVELos Angeles, CA 90029-3405

Mailing Address27 Randolph RdHowell, NJ 07731-8611

Phone(848) 210-4422

Organization SubpartNo

Authorized OfficialDov NewmarkCeo · (732) 567-3438

Enumeration DateNovember 29, 2023

NPPES CertifiedNovember 29, 2023

✔ NPI 1740056993 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X

Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X

Also ListedNurse PractitionerTaxonomy 363L00000X

826 N MARIPOSA AVE, Los Angeles, CA 90029

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Roosevelt Care Of California Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Roosevelt Care Of California PC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Robert Glenn, MD

Psychiatry

NPI 1902033210

501 W REDLANDS BLVD STE B
Redlands, CA 92373

(909) 686-6233

✔ PECOS✔ Accepts Medicare65 mi

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

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 Roosevelt Care Of California PC's NPI number?

The NPI number for Roosevelt Care Of California PC is 1740056993. It was assigned to this organization in the NPPES registry on November 29, 2023.

Where is Roosevelt Care Of California PC located?

Roosevelt Care Of California PC is located at 826 N Mariposa Ave, Los Angeles, CA 90029. The listed phone number is (848) 210-4422.

What is Roosevelt Care Of California PC's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Roosevelt Care Of California PC enrolled in Medicare?

Yes. Roosevelt Care Of California PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Roosevelt Care Of California PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Psychiatry) reassigns their Medicare billing to Roosevelt Care Of California PC. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Roosevelt Care Of California PC was last updated on November 29, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.