Grigoriy Tsotneevich Rodonaia, M.D. PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

M6986 Issued in TX

Practice address

2955 Harrison St
Ste. 200
Beaumont, TX 77702-1154

Phone

(409) 923-1617

Fax

(409) 923-1618

NPI assigned

May 31, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

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.

• Christus Health Southeast Texas

  • Rural Acute Care Hospital
  • Jasper, TX
  • NPI 1598749707
  NPD (past)

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266537600000",
    "number": "1023210317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2955 HARRISON ST",
            "address_2": "STE. 200",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777021154",
            "telephone_number": "409-923-1617",
            "fax_number": "409-923-1618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2955 HARRISON ST",
            "address_2": "STE. 200",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777021154",
            "telephone_number": "409-923-1617",
            "fax_number": "409-923-1618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODONAIA",
        "first_name": "GRIGORIY",
        "middle_name": "TSOTNEEVICH",
        "credential": "M.D.  PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-31",
        "last_updated": "2010-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "M6986",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8BX338",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Alan Roche, PHYSICAL THERAPIST
• Edward F Rod Jr., D.D.S.
• Sean Michael Roden, D.C., B.S., CCSP
• Myrna Cruz Roderick, NURSE PRACTITIONER
• Lynn Smith Rodgers, MS, LPC
• Ofelia Rodriguez Sierra, PTA
• Shelby Nicole Rodriguez, ATC, LAT
• Stephanie Ann Rodriguez, LCDC
• Jeremy Christopher Roebuck, MD
• Nathan R Roesler, M.D.

• Family Medicine Physician in Beaumont, TX
• Providers in Beaumont, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.