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Justin Maxwell Rogoski

Internal Medicine

Allopathic & Osteopathic Physicians

1250 16th St Ste 2304, Santa Monica, CA 90404-1249

PECOS Enrollment

This provider is enrolled in PECOS as JUSTIN ROGOSKI.

Based on the most recent information from CMS, provider Justin Maxwell Rogoski is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 6 days ago.

Profile Details

Provider ID
1770100794
Provider Type
Individual
Full Name
Rogoski, Justin Maxwell
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
6/26/2020
Last Updated
8/3/2023

Contact Information

Practice Location

1250 16th St Ste 2304, Santa Monica, CA 90404-1249

(855) 488-9550

Unlisted Fax

Mailing Location

5767 W Century Blvd Ste 400, Los Angeles, CA 90045-5631

(310) 301-8707

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License 186595 California
Code 208M00000X	Description Hospitalist Allopathic & Osteopathic Physicians	License A186595 California

Justin Maxwell Rogoski

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

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