Individual provider Active NPI

Ellen B Rodman, DO

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Pensacola, FL
National Provider Identifier
1033149273
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
1019935 Issued in MA
Practice address
5151 N 9TH Ave # ER
Pensacola, FL 32504-8721
Phone
(850) 416-7000
Fax
(850) 475-4781
NPI assigned
Jul 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X OS0007797 FL
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 1019935 MA Primary

Addresses

Primary practice location

5151 N 9TH Ave # ER
Pensacola, FL 32504-8721

Mailing address

PO Box 2699
Attn: SHMG/Hpe
Pensacola, FL 32513-2699
Phone (850) 416-7000

Other practice location 1

300 Longwood Ave
Boston, MA 02115-5724
Phone (617) 355-6000

Other practice location 2

55 Fogg Rd
S Weymouth, MA 02190-2432
Phone (781) 624-8000

Other identifiers 2

IdentifierTypeStateIssuer
256279100MedicaidFL
46616OtherFLBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, IL, MA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20051015000069 FL Practitioner - Emergency MedicinePractitioner - Pediatric Medicine 9638195092 Reassigns benefits to 1 organization
I20120618000065 IL Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 9638195092 Reassigns benefits to 1 organization
I20240816002149 MA Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 9638195092 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS0007797FLMDEmergency Medicine Physician
1019935MAMDPediatric Emergency Medicine (Pediatrics) Physician
1199ALMDRegistered Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Panhandle Emergency Physicians a Div of Sacred Heart Hosp Pensacola Emergency Medicine CurrentSince Sep 1, 2014 Accepting new patients
Children's Hospital Pediatric Associates, Inc Pediatric Emergency Medicine CurrentSince Aug 15, 2024 Accepting new patients
The University of Chicago Medical Center CurrentSince Oct 1, 2020 Accepting new patients
Boston Medical Center Corporation Current Accepting new patients
Baystate Medical Practices, Inc CurrentSince Sep 23, 2024 Accepting new patients
The University of Chicago Medical Center CurrentSince Oct 1, 2020 Accepting new patients

Locations

5151 N 9th Ave
Pensacola, FL 32504
Phone (850) 202-4700

150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061

960 Massachusetts Ave
Ste 2
Boston, MA 02118

300 Longwood Ave
Boston, MA 02115
Phone (617) 355-4956

759 Chestnut St
Springfield, MA 01199
Phone (413) 794-3233

55 Fogg Rd
Weymouth, MA 02190
Phone (781) 340-4293

Interoperability endpoints

  • Direct secure messaging: erodman245814@direct.bmc.masshiway.net
  • Direct secure messaging: erodmanmd44689@uchospital.direct-ci.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1033149273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2699",
            "address_2": "ATTN: SHMG/HPE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325132699",
            "telephone_number": "850-416-7000",
            "fax_number": "850-475-4781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5151 N 9TH AVE # ER",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048721",
            "telephone_number": "850-416-7000",
            "fax_number": "850-475-4781"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Longwood Ave",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021155724",
            "country_code": "US",
            "telephone_number": "617-355-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "55 Fogg Rd",
            "address_purpose": "LOCATION",
            "city": "S Weymouth",
            "state": "MA",
            "postal_code": "021902432",
            "country_code": "US",
            "telephone_number": "781-624-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODMAN",
        "first_name": "ELLEN",
        "middle_name": "B",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "OS0007797",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "MA",
            "license": "1019935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "256279100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "46616",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.