Individual provider Active NPI

David Leonard Rodibaugh, M.D.

  • Diagnostic Radiology Physician
  • Santa Ana, CA
National Provider Identifier
1083656508
Registry record updated May 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
C33122 Issued in CA
Practice address
1100 N Tustin Ave
Santa Ana, CA 92705-3509
Phone
(714) 835-6055
Fax
(714) 835-3287
NPI assigned
Jun 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2014

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging Physician 2085B0100X C33122 CA
Neuroradiology Physician 2085N0700X C33122 CA
Diagnostic Radiology Physician 2085R0202X C33122 CA Primary
Vascular & Interventional Radiology Physician 2085R0204X C33122 CA
Diagnostic Ultrasound Physician 2085U0001X C33122 CA

Addresses

Primary practice location

1100 N Tustin Ave
Santa Ana, CA 92705-3509

Mailing address

1 Saint Raphael
Laguna Niguel, CA 92677-2761
Phone (714) 835-3709

Other identifiers 1

IdentifierTypeStateIssuer
00C331220MedicaidCA

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
I20040301001300 CA Practitioner - Diagnostic Radiology 1052210515 Reassigns benefits to 13 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Indiana University School of Medicine, 1969
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beverly Radiology Medical Group IIIGroup PAC ID 3476466376, 327 clinicians

Practice addresses (Care Compare)

1100 N Tustin Ave
Suite a
Santa Ana, CA 92705-3509
Phone (714) 835-6055

16130 Ventura Blvd
Suite 100
Encino, CA 91436-2517
Phone (818) 933-2020

16300 Sand Canyon Ave
Suite 102
Irvine, CA 92618-3704
Phone (949) 753-0900

17762 Beach Blvd
Suite 110
Huntington Beach, CA 92647-6860
Phone (585) 218-8007

18785 Brookhurst St
Suite 102
Fountain Valley, CA 92708-7300
Phone (714) 417-9950

230 S Main St
Orange, CA 92868-3851

23961 Calle de la Magdalena
Suite 243
Laguna Hills, CA 92653-3600
Phone (949) 272-2202

2708 E Willow St
Signal Hill, CA 90755-2217
Phone (562) 216-5120

3300 W Coast Hwy
Suite B
Newport Beach, CA 92663-4025
Phone (949) 726-9100

6440 S St
Lakewood, CA 90713-1713
Phone (562) 299-6230

675 Camino de Los Mares
Suite 101
San Clemente, CA 92673-2836
Phone (949) 493-8799

8750 Wilshire Blvd
Suite 100
Beverly Hills, CA 90211-2708
Phone (310) 689-3100

9191 Westminster
Ave 210
Garden Grove, CA 92844-2751
Phone (714) 784-1657

9191 Westminster Ave
Garden Grove, CA 92844-2751
Phone (714) 784-1657

947 S Anaheim Blvd
Anaheim, CA 92805-5582
Phone (714) 758-9800

Merit-based Incentive Payment System (MIPS)

Final score
91.25 of 100Reported as group
Quality
75
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C33122CAMDDiagnostic Ultrasound Physician
33122CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Beverly Radiology Medical Group III Diagnostic Radiology CurrentSince Dec 1, 2017 Accepting new patients
Beverly Radiology Medical Group III Diagnostic Radiology CurrentSince May 5, 2012 Accepting new patients
Norcal Imaging Diagnostic Radiology CurrentSince Jan 23, 2018 Accepting new patients
Pronet Imaging Medical Group, Inc. Diagnostic Radiology CurrentSince Dec 1, 2017 Accepting new patients
Radnet Medical Imaging-San Francisco Diagnostic Radiology CurrentSince Dec 1, 2017 Accepting new patients
Desert Advanced Imaging Medical Center Diagnostic Radiology CurrentSince Dec 1, 2017 Accepting new patients
Modesto Advanced Diagnostic Imaging Medical Center Diagnostic Radiology CurrentSince Dec 1, 2017 Accepting new patients
Norcal Imaging Diagnostic Radiology CurrentSince Jan 23, 2018 Accepting new patients
Santa Rosa Imaging Medical Center Diagnostic Radiology CurrentSince Dec 1, 2017 Accepting new patients
San Fernando Valley Interventional Radiology and Imaging Center CurrentSince Dec 1, 2017 Accepting new patients
Stockton Diagnostic Imaging Diagnostic Radiology CurrentSince Dec 1, 2017 Accepting new patients
Fresno Imaging Center Diagnostic Radiology CurrentSince Dec 1, 2017 Accepting new patients
Beverly Radiology Medical Group III Diagnostic Radiology CurrentSince May 5, 2012 Accepting new patients
Diagnostic Radiological Imaging Diagnostic Radiology CurrentSince Dec 1, 2017 Accepting new patients
Beverly Radiology Medical Group Diagnostic Radiology Past Accepting new patients
Kern Radiology Medical Group, Inc Diagnostic Radiology Past Accepting new patients
Santa Ana Tustin Radiology Medical Group Body Imaging Past Accepting new patients

Locations (25 of 40)

18523 Corwin Rd
Ste J
Apple Valley, CA 92307
Phone (760) 242-4444

8750 Wilshire Blvd
Ste 100
Beverly Hills, CA 90211
Phone (310) 689-3100

2601 W Alameda Ave
Ste 101
Burbank, CA 91505
Phone (818) 843-7462

801 S Main St
Ste 101
Corona, CA 92882
Phone (951) 682-1099

801 S Main St
Ste 205
Corona, CA 92882
Phone (951) 351-1025

16311 Ventura Blvd
Ste 120
Encino, CA 91436
Phone (818) 817-7707

16130 Ventura Blvd
Ste 100
Encino, CA 91436
Phone (818) 933-2020

2201 Walnut Ave
Ste 150
Fremont, CA 94538
Phone (510) 713-1234

6107 N Fresno St
Ste 101
Fresno, CA 93710
Phone (559) 435-4433

6191 N Thesta St
Fresno, CA 93710
Phone (559) 435-7200

9191 Westminster Ave
Ste 105
Garden Grove, CA 92844
Phone (714) 583-6314

250 S 12th Ave
Hanford, CA 93230
Phone (559) 295-2450

2679 Zoe Ave
Huntington Park, CA 90255
Phone (323) 584-3333

16300 Sand Canyon Ave
Ste 102
Irvine, CA 92618
Phone (949) 753-0900

16300 Sand Canyon Ave
Ste 203
Irvine, CA 92618
Phone (949) 753-9090

27882 Forbes Rd
Ste 120
Laguna Niguel, CA 92677
Phone (949) 272-2200

11360 Mountain View Ave
Ste C
Loma Linda, CA 92354
Phone (909) 478-3300

3715 E South St
Long Beach, CA 90805
Phone (562) 602-0700

4910 Airport Plaza Dr
Long Beach, CA 90815
Phone (562) 429-2473

3320 N Los Coyotes Diagonal
Ste 120
Long Beach, CA 90808
Phone (562) 627-0903

1516 Cotner Ave
Los Angeles, CA 90025
Phone (310) 445-2843

1510 Cotner Ave
Los Angeles, CA 90025
Phone (310) 445-2851

27168 Newport Rd
Ste B
Menifee, CA 92584
Phone (951) 566-5725

157 E Coolidge Ave
Modesto, CA 95350
Phone (209) 524-6800

25395 Hancock Ave
Ste 110
Murrieta, CA 92562
Phone (951) 696-4230

Organizations & group practices 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399593600000",
    "number": "1083656508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SAINT RAPHAEL",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926772761",
            "telephone_number": "714-835-3709",
            "fax_number": "714-835-3287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 N TUSTIN AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053509",
            "telephone_number": "714-835-6055",
            "fax_number": "714-835-3287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODIBAUGH",
        "first_name": "DAVID",
        "middle_name": "LEONARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-11",
        "last_updated": "2014-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "CA",
            "license": "C33122",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "CA",
            "license": "C33122",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "C33122",
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "CA",
            "license": "C33122",
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "CA",
            "license": "C33122",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C331220",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.