Individual provider Active NPI

Stephen Edward Rodriguez, M.D.

  • Pain Medicine (Psychiatry & Neurology) Physician
  • Bethesda, MD
National Provider Identifier
1063752509
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084P2900X
License
136156 Issued in CA
Practice address
8901 Wisconsin Ave
Bethesda, MD 20889-1098
Phone
(301) 295-2801
NPI assigned
Feb 20, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 136156 CA
Pain Medicine (Psychiatry & Neurology) Physician 2084P2900X 136156 CA Primary

Addresses

Primary practice location

8901 Wisconsin Ave
Bethesda, MD 20889-1098

Mailing address

8901 Wisconsin Ave
Bethesda, MD 20889-0004
Phone (301) 319-2327

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
I20210630001527 CA Order and Referring Only - PsychiatryPractitioner - Psychiatry 0244631083

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
136156CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1361318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1063752509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8901 WISCONSIN AVE",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208890004",
            "telephone_number": "301-319-2327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8901 WISCONSIN AVE",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208891098",
            "telephone_number": "301-295-2801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "STEPHEN",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-20",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "136156",
            "primary": false
        },
        {
            "code": "2084P2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Pain Medicine",
            "state": "CA",
            "license": "136156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

Verify at the official NPI Registry.