Individual provider Active NPI

Rohit P Rao, M.D.

  • Pediatric Critical Care Medicine Physician
  • San Diego, CA
National Provider Identifier
1063452779
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
C54276 Issued in CA
Practice address
3020 Childrens Way
San Diego, CA 92123-4223
Phone
(858) 966-5855
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X C54276 CA
Pediatrics Physician 208000000X 44584 AZ
Pediatric Cardiology Physician 2080P0202X 44584 AZ
Pediatric Critical Care Medicine Physician 2080P0203X 44584 AZ
Pediatric Cardiology Physician 2080P0202X C54276 CA
Pediatric Critical Care Medicine Physician 2080P0203X C54276 CA Primary

Addresses

Primary practice location

3020 Childrens Way
San Diego, CA 92123-4223

Mailing address

3020 Childrens Way # Mc5003
San Diego, CA 92123-4223
Phone (858) 309-6300

Other practice location 1

1919 E Thomas Rd
Phoenix, AZ 85016-7710
Phone (602) 933-1784

Other identifiers 2

IdentifierTypeStateIssuer
635030MedicaidAZ
32620300MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, CA2 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

Enrollment IDStateProvider typePAC IDDetails
I20111018000862 AZ Practitioner - Other (Physician)Practitioner - Pediatric Medicine 2466456421 Reassigns benefits to 1 organization
I20170913003927 CA Practitioner - Critical Care (Intensivists)Practitioner - Pediatric MedicinePractitioner - Cardiovascular Disease (Cardiology) 2466456421 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C54276CAMDPediatrics Physician
44584AZMDPediatric Critical Care Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rady Children'S Hospital San Diego CurrentSince Aug 15, 2017 Accepting new patients
Phoenix Children'S Medical Group CurrentSince Jul 31, 2011 Accepting new patients
Rady Children'S Hospital San Diego Pediatrics CurrentSince Aug 15, 2017 Accepting new patients
Phoenix Children'S Hospital Pediatrics Current Accepting new patients
Marilyn Kaufhold, M.D., a Medical Corporation PastSince Jul 24, 2022 Accepting new patients

Locations

1551 E Tangerine Rd
Ste 141
Oro Valley, AZ 85755
Phone (520) 320-7999

1919 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 933-0777

726 Gail Gardner Way
Ste A
Prescott, AZ 86305
Phone (928) 443-9580

25170 Hancock Ave
Murrieta, CA 92562
Phone (858) 757-3277

3020 Childrens Way
#5003
San Diego, CA 92123
Phone (858) 309-6300

3020 Childrens Way
San Diego, CA 92123
Phone (858) 966-5841

Organizations & group practices 5

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1063452779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 CHILDRENS WAY # MC5003",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234223",
            "telephone_number": "858-309-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 CHILDRENS WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234223",
            "telephone_number": "858-966-5855"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1919 E Thomas Rd",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850167710",
            "country_code": "US",
            "telephone_number": "602-933-1784",
            "fax_number": "602-933-1785",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAO",
        "first_name": "ROHIT",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "C54276",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "44584",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "AZ",
            "license": "44584",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "AZ",
            "license": "44584",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "CA",
            "license": "C54276",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "CA",
            "license": "C54276",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "635030",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32620300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.