Individual provider Active NPI

Johana Rodriguez, M.D.

  • Internal Medicine Physician
  • Anaheim, CA
National Provider Identifier
1043691389
Registry record updated Aug 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A147089 Issued in CA
Practice address
1182 N Euclid St
Anaheim, CA 92801-1900
Phone
(714) 399-9222
NPI assigned
Jun 12, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X A147089 CA Primary

Addresses

Primary practice location

1182 N Euclid St
Anaheim, CA 92801-1900

Mailing address

12900 Park Plaza Dr Ste 150
Cerritos, CA 90703-9329
Phone (562) 977-4639

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210318000601 CA Practitioner - Internal Medicine 8325397581 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A147089CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Albion Medical Partners of California West P C Internal Medicine CurrentSince Mar 1, 2021 Accepting new patients

Locations

12900 Park Plaza Dr
Ste 700
Cerritos, CA 90703
Phone (562) 622-2800

12900 Park Plaza Dr
Ste 150
Cerritos, CA 90703
Phone (562) 622-2800

Interoperability endpoints

  • Direct secure messaging: johana.rodriguez.p5@direct.caremorewest.nextgenshare.com
  • Direct secure messaging: johana.rodriguez.1@30710.direct.athenahealth.com
  • Direct secure messaging: johana.rodriguez.p1@direct.caremorewest.nextgenshare.com

Organizations & group practices 1

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": "1434067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567036800000",
    "number": "1043691389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12900 PARK PLAZA DR STE 150",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907039329",
            "telephone_number": "562-977-4639",
            "fax_number": "562-741-4479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1182 N EUCLID ST",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928011900",
            "telephone_number": "714-399-9222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JOHANA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-12",
        "last_updated": "2019-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A147089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.