Wyatt Rodan, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MD484015 Issued in PA

Practice address

4815 Liberty Ave Ste 439
Pittsburgh, PA 15224-2156

Phone

(412) 359-4373

NPI assigned

Apr 14, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA, OR2 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 2

Specialty

Orthopedic Surgery

Education

Oregon Health Sciences University School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Centennial Medical Group IncGroup PAC ID 6103982962, 60 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Medical Center Hospital, Roseburg, OR, CCN 380027

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• WA PPO C-SNP
• devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e

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.

• Centennial Medical Group Inc.

  • Surgery Physician
  • Roseburg, OR
  • NPI 1518103274
  Medicare reassignment Care Compare group NPD
• Allegheny Clinic

  • Family Medicine Physician
  • Bethel Park, PA
  • NPI 1073081493
  Medicare reassignment NPD
• Allegheny Clinic

  • Primary Care Clinic/Center
  • Pittsburgh, PA
  • NPI 1215752548
  NPD
• Allegheny Clinic

  • Surgery Physician
  • Pittsburgh, PA
  • NPI 1568462984
  NPD
• Allegheny Clinic

  • Cardiovascular Disease Physician
  • Pittsburgh, PA
  • NPI 1629078332
  NPD (past)

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

• Commonspirit Oregon

  • General Acute Care Hospital
  • Roseburg, OR
  • NPI 1477590198
  Care Compare affiliation

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

{
    "created_epoch": "1460592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1053765263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4815 LIBERTY AVE STE 439",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152242156",
            "telephone_number": "412-359-4373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4815 LIBERTY AVE STE 439",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152242156",
            "telephone_number": "412-359-4373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODAN",
        "first_name": "WYATT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-14",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD484015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "16212653",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kiara Rockymore, CPD
• Karen Roda
• Sasha Nichole Roda
• Emily Sarah Rodak, PA-C
• Juleen Rodakowski, OTD, OTR/L
• Barry Vincent Rodden Jr., PT
• Chelsea Rodemoyer
• Ann Katherine Rodgers, DPT
• Christine Elizabeth Rodgers
• Emily Rodgers, LPC

• Surgery Physician in Pittsburgh, PA
• Providers in Pittsburgh, PA by specialty
• Surgery Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.