Jay S. Roden, M.D.

Primary specialty

Pediatric Surgery PhysicianTaxonomy code 2086S0120X

License

G0019 Issued in TX

Practice address

12200 Park Central Dr Ste 400
Dallas, TX 75251-2116

Phone

(214) 483-9300

Fax

(214) 483-9301

NPI assigned

Oct 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: jroden460405@direct.sw.org

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.

• Magella Medical Associates Billing, Inc.

  • Neonatal-Perinatal Medicine Physician
  • Round Rock, TX
  • NPI 1083631071
  Medicare reassignment
• Pediatric Surgical Associates

  • Pediatric Surgery Physician
  • Plano, TX
  • NPI 1508995358
  NPD (past)

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

{
    "created_epoch": "1161388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589155200000",
    "number": "1093898447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12200 PARK CENTRAL DR STE 400",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752512116",
            "telephone_number": "214-483-9300",
            "fax_number": "214-483-9301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12200 PARK CENTRAL DR STE 400",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752512116",
            "telephone_number": "214-483-9300",
            "fax_number": "214-483-9301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODEN",
        "first_name": "JAY",
        "middle_name": "S.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-21",
        "last_updated": "2020-05-11",
        "certification_date": "2020-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "TX",
            "license": "G0019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1330870-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rod J Rohrich MD PA
• Tammie Rodaway, NNP
• Susan Joan Rodder, MS RD LD
• Rachel Rode, M.S., LPC
• Vicki Heather Roden Sorokolit, CRNA
• Mary Grace Roden, MS
• Charlena L Rodez, OT
• Deepashikha Rodge, PT
• Rodger D. Kobes MD PHD PA
• Brandon Neil Rodgers, PT, DPT, ATC

• Pediatric Surgery Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Pediatric Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.