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JUSTIN ROLDAN
NPI 1922363993
Nurse Anesthetist, Certified Registered in Harbor City, CA

Active since July 05, 2012
25825 VERMONT AVE, HARBOR CITY, CA 90710(310) 325-5111 Get Directions Write a Review

NPPES record last updated: November 19, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 19, 2021, Jul 20, 2018 (2 updates tracked since 2018).

About Justin Roldan NPPES

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

JUSTIN ROLDAN (NPI 1922363993) is an individual nurse anesthetist, certified registered in Harbor City, California, licensed in California (4264) and active in the NPI registry since July 2012.

NPPES Registry Identity

NPI1922363993
Entity TypeIndividualMale
Primary Taxonomy367500000X
Provider Legal NameJUSTIN ROLDAN
Location Address25825 VERMONT AVEHarbor City, CA 90710-3518
Mailing Address25825 Vermont AveHarbor City, CA 90710-3518 · (310) 325-5111
Phone(310) 325-5111
Sole ProprietorYes
Enumeration DateJuly 5, 2012
Last NPPES UpdateNovember 19, 20212 updates tracked since enumeration
NPPES CertifiedNovember 19, 2021
✔ NPI 1922363993 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
License✔ Licensed in CA · 4264
Definition
(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.
25825 VERMONT AVE, Harbor City, CA 90710
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Justin Roldan is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignments

4

Medicare enrollment records show Justin Roldan reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Southern California Permanente Medical Group
Same address
Health Maintenance Organization
25825 VERMONT AVE
Harbor City, CA 90710
  • Reassigned Medicare billing, California enrollment
  • 13,921 clinicians in this Medicare group
NPI 1598797011 (310) 325-5111
San Gabriel Anesthesia Associates, PC
27 mi
Nurse Anesthetist, Certified Registered
1403 N TUSTIN AVE STE 100
Santa Ana, CA 92705
  • Reassigned Medicare billing, California enrollment
  • 40 clinicians in this Medicare group
NPI 1538424908 (714) 633-1338
Glendora Anesthesia Associates LP
32 mi
Nurse Anesthetist, Certified Registered
1794 S BARRANCA AVE
Glendora, CA 91740
  • Reassigned Medicare billing, California enrollment
  • 43 clinicians in this Medicare group
NPI 1750748331 (626) 858-4600
Marquee Anesthesia Consultants Inc
64 mi
Nurse Anesthetist, Certified Registered
10408 INDUSTRIAL CIR
Redlands, CA 92374
  • Reassigned Medicare billing, California enrollment
  • 35 clinicians in this Medicare group
NPI 1760942619 (775) 747-5050

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

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Anesthesia for lens surgery 00142
Anesthesia for lens surgery involves administering medication to numb the eye area, ensuring you feel no pain during the procedure. This can be a local anesthetic (numbing only the eye area) or general (where you're asleep). It helps make the surgery comfortable and stress-free.
18 services15 patients

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.

SEAN KOH PHARM.D.
Pharmacist
25825 VERMONT AVE
HARBOR CITY, CA 90710
Los Angeles County (310) 325-5111
ALYSSA QUAN PHARM.D.
Pharmacist
25825 VERMONT AVE
HARBOR CITY, CA 90710
Los Angeles County (310) 517-2238
JOYHAN JAY SUNG RRT-NPS
Respiratory Therapist, Registered (Neonatal/Pediatrics)
25825 VERMONT AVE
HARBOR CITY, CA 90710
Los Angeles County (310) 517-2648
RANDEL R. KING MD
Internal Medicine (Pulmonary Disease)
25825 VERMONT AVE
HARBOR CITY, CA 90710
Los Angeles County (310) 325-5111
TIM TAKESHI SUGIYAMA
Pharmacist
25825 VERMONT AVE
HARBOR CITY, CA 90710
Los Angeles County (310) 517-2239
RYOKEI K. IMAI MD
Internal Medicine
25825 VERMONT AVE
HARBOR CITY, CA 90710
Los Angeles County (310) 325-5111
JENNIFER WING-YUN LAM MD
Internal Medicine
25825 VERMONT AVE
HARBOR CITY, CA 90710
Los Angeles County (310) 325-5111
CHRISTOPHER LOLACHI MD
Otolaryngology (Plastic Surgery within the Head & Neck)
25825 VERMONT AVE
HARBOR CITY, CA 90710
Los Angeles County (310) 325-5111

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 Justin Roldan's NPI number?

The NPI number for Justin Roldan is 1922363993. It was assigned to this individual provider in the NPPES registry on July 5, 2012.

Where is Justin Roldan located?

Justin Roldan practices at 25825 Vermont Ave, Harbor City, CA 90710. The listed phone number is (310) 325-5111.

What is Justin Roldan's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Is Justin Roldan enrolled in Medicare?

Yes. Justin Roldan is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Justin Roldan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Justin Roldan reassigns Medicare benefits to 4 organizations: Southern California Permanente Medical Group (Harbor City, CA), San Gabriel Anesthesia Associates, PC (Santa Ana, CA), Glendora Anesthesia Associates LP (Glendora, CA) and Marquee Anesthesia Consultants Inc (Redlands, CA). Each 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 Justin Roldan'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 Justin Roldan was last updated on November 19, 2021. 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.