Javier Rodriguez, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A82639 Issued in CA

Practice address

4060 Fairmount Ave
Pediatrics Department
San Diego, CA 92105-1608

Phone

(619) 255-9154

Fax

(619) 795-9847

NPI assigned

Feb 13, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: javier.rodriguez.p1@direct.lamaestra.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• La Maestra Family Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • El Cajon, CA
  • NPI 1306929443
  Medicare reassignment NPD
• La Maestra Family Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • El Cajon, CA
  • NPI 1568209773
  NPD
• La Maestra Family Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1609849074
  NPD
• La Maestra Family Clinic

  • Federally Qualified Health Center (FQHC)
  • National City, CA
  • NPI 1336324904
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1013059385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4060 FAIRMOUNT AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921051608",
            "telephone_number": "619-280-4213",
            "fax_number": "619-280-3545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4060 FAIRMOUNT AVE",
            "address_2": "PEDIATRICS DEPARTMENT",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921051608",
            "telephone_number": "619-255-9154",
            "fax_number": "619-795-9847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JAVIER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A82639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THE AMERICAN BOARD OF PEDIATRICS",
            "identifier": "25622",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ivette G Rodriguez
• Jacqueline Guadalupe Rodriguez
• Jaden Rodriguez
• James Manuel Rodriguez, DDS
• Janet Rose Rodriguez II, MFT
• Javier Rodriguez
• Jennifer Rodriguez, NONE
• Jennifer Rodriguez
• Jennifer Danielle Rodriguez
• Jessica Rodriguez

• Pediatrics Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.