Individual provider Active NPI

Marlene V Rodriguez, MD

  • Family Medicine Physician
  • Northfield, NJ
National Provider Identifier
1093822090
Registry record updated Feb 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MA066529 Issued in NJ
Practice address
2605 Shore Rd
Northfield, NJ 08225-2136
Phone
(609) 365-5300
Fax
(609) 365-5306
NPI assigned
Aug 24, 2006
Last updated
Feb 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MA066529 NJ Primary

Addresses

Primary practice location

2605 Shore Rd
Northfield, NJ 08225-2136

Mailing address

1 E. New York Ave
4TH Floor - SPG
Somers Point, NJ 08244
Phone (609) 653-3994

Other identifiers 1

IdentifierTypeStateIssuer
8364702MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20100625000347 NJ Practitioner - Family Practice 7113058793 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Shore Memorial Physicians Group PCGroup PAC ID 4688845191, 25 clinicians

Practice addresses (Care Compare)

2605 Shore Rd
Northfield, NJ 08225-2136
Phone (609) 365-5300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA066529NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanticare Regional Medical Center Past Accepting new patients
Shore Memorial Hospital Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: marlene.rodriguez.1@4024.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612224000000",
    "number": "1093822090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 E. NEW YORK AVE",
            "address_2": "4TH FLOOR - SPG",
            "city": "SOMERS POINT",
            "state": "NJ",
            "postal_code": "08244",
            "telephone_number": "609-653-3994",
            "fax_number": "609-926-4311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 SHORE RD",
            "city": "NORTHFIELD",
            "state": "NJ",
            "postal_code": "082252136",
            "telephone_number": "609-365-5300",
            "fax_number": "609-365-5306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "MARLENE",
        "middle_name": "V",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-24",
        "last_updated": "2021-02-02",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MA066529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8364702",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Northfield, NJ

Sources for this page

Verify at the official NPI Registry.