Individual provider Active NPI

Alexandria Caroline Roden, MD

  • Family Medicine Physician
  • Niles, MI
National Provider Identifier
1013470178
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301512811 Issued in MI
Practice address
4 Longmeadow Village Dr
Niles, MI 49120-7809
Phone
(269) 684-6000
NPI assigned
Apr 7, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X T5014 TX
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 4301512811 MI Primary

Addresses

Primary practice location

4 Longmeadow Village Dr
Niles, MI 49120-7809

Mailing address

4 Longmeadow Village Dr
Niles, MI 49120-7809
Phone (269) 684-6000

Other practice location 1

10615 W Grand Pkwy S
Richmond, TX 77407-8692
Phone (713) 798-1750 ext. 2

Other practice location 2

1234 Napier Ave
Saint Joseph, MI 49085-2112
Phone (269) 982-4941

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20241118000111 MI Practitioner - Family Practice 5395073746 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lakeland Medical PracticesGroup PAC ID 1658427042, 286 clinicians

Practice addresses (Care Compare)

4 Longmeadow Village Dr
Suite 2
Niles, MI 49120-7809
Phone (269) 684-6000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
T5014TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Medical Practices CurrentSince Nov 1, 2024 Accepting new patients
Lakeland Medical Practices CurrentSince Nov 1, 2024 Accepting new patients

Locations

4 Longmeadow Village Dr
Ste 2
Niles, MI 49120
Phone (269) 684-6000

4 Longmeadow Village Dr
Niles, MI 49120
Phone (269) 684-6000

3950 Hollywood Rd
Ste 280
Saint Joseph, MI 49085
Phone (269) 408-0990

1234 Napier Ave
Saint Joseph, MI 49085
Phone (269) 982-4941

Interoperability endpoints

  • Direct secure messaging: aroden270201@direct.stlukeshealth.org
  • Direct secure messaging: aroden1693715@epic00.shdirect.org

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1554595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737676800000",
    "number": "1013470178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 LONGMEADOW VILLAGE DR",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491207809",
            "telephone_number": "269-684-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 LONGMEADOW VILLAGE DR",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491207809",
            "telephone_number": "269-684-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10615 W Grand Pkwy S",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "TX",
            "postal_code": "774078692",
            "country_code": "US",
            "telephone_number": "713-798-1750 x2",
            "fax_number": "713-798-4693",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1234 Napier Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Joseph",
            "state": "MI",
            "postal_code": "490852112",
            "country_code": "US",
            "telephone_number": "269-982-4941",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODEN",
        "first_name": "ALEXANDRIA",
        "middle_name": "CAROLINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-07",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "T5014",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301512811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, MI

Sources for this page

Verify at the official NPI Registry.