Individual provider Active NPI

Juan Manuel Rodriguez, PSY.D.

  • Psychologist
  • San Francisco, CA
National Provider Identifier
1043406689
Registry record updated Jul 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
759 S Van Ness Ave
San Francisco, CA 94110-1908
Phone
(415) 642-4550
NPI assigned
Sep 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X Primary

Addresses

Primary practice location

759 S Van Ness Ave
San Francisco, CA 94110-1908

Mailing address

759 S Van Ness Ave
San Francisco, CA 94110-1908
Phone (415) 642-4528

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170509001847 CA Practitioner - Clinical Psychologist 3375839848 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
City and County of San FranciscoGroup PAC ID 1658280748, 368 clinicians

Practice addresses (Care Compare)

1701 Ocean Ave
San Francisco, CA 94112-1727
Phone (415) 452-2200

760 Harrison St
San Francisco, CA 94107-1235
Phone (415) 836-1700

Merit-based Incentive Payment System (MIPS)

Final score
88.2 of 100Reported as group
Quality
61.12
Promoting interoperability
99
Improvement activities
40
Cost
83.72

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26944CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
City and County of San Francisco CurrentSince Apr 1, 2017 Accepting new patients
City & County of San Francisco CurrentSince Apr 1, 2017 Accepting new patients
City & County of San Francisco Current Accepting new patients

Locations

760 Harrison St
San Francisco, CA 94107
Phone (415) 836-1700

1701 Ocean Ave
San Francisco, CA 94112
Phone (415) 255-3699

Organizations & group practices 3

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": "1190073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405468800000",
    "number": "1043406689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "759 S VAN NESS AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941101908",
            "telephone_number": "415-642-4528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "759 S VAN NESS AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941101908",
            "telephone_number": "415-642-4550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JUAN",
        "middle_name": "MANUEL",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-18",
        "last_updated": "2014-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.