Individual provider Active NPI

Rodrigo Alba Mariano, MD

  • Internal Medicine Physician
  • Fort Sill, OK
National Provider Identifier
1093819740
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20512 Issued in OK
Practice address
4301 Mow Way Rd
Reynolds Army Community Hospital
Fort Sill, OK 73503-6300
Phone
(580) 458-2246
Fax
(580) 458-3433
NPI assigned
Sep 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 20512 OK Primary

Addresses

Primary practice location

4301 Mow Way Rd
Reynolds Army Community Hospital
Fort Sill, OK 73503-6300

Mailing address

310 NW Morford Dr
Lawton, OK 73507-6333
Phone (580) 595-4800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20130613000622 OK Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 4880833326

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson County Memorial Hospital Authority Past Accepting new patients

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": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093819740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 NW MORFORD DR",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735076333",
            "telephone_number": "580-595-4800",
            "fax_number": "580-595-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 MOW WAY RD",
            "address_2": "REYNOLDS ARMY COMMUNITY HOSPITAL",
            "city": "FORT SILL",
            "state": "OK",
            "postal_code": "735036300",
            "telephone_number": "580-458-2246",
            "fax_number": "580-458-3433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARIANO",
        "first_name": "RODRIGO",
        "middle_name": "ALBA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "20512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Sill, OK

Sources for this page

Verify at the official NPI Registry.