Individual provider Active NPI

Elizabeth J Rody, MD

  • Psychiatry Physician
  • San Mateo, CA
National Provider Identifier
1093930109
Registry record updated Jan 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
G86385 Issued in CA
Practice address
1950 Alameda de Las Pulgas
San Mateo, CA 94403-1222
Phone
(650) 587-8574
NPI assigned
Apr 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X G86385 CA Primary

Addresses

Primary practice location

1950 Alameda de Las Pulgas
San Mateo, CA 94403-1222

Mailing address

1950 Alameda de Las Pulgas
San Mateo, CA 94403-1222
Phone (650) 587-8574

Other identifiers 2

IdentifierTypeStateIssuer
8636OtherCBHS INTERNAL USE ONLY-COMMERCIAL NUMBER
8636OtherSFGH INTERNAL USE ONLY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G86385CAMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1093930109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 ALAMEDA DE LAS PULGAS",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944031222",
            "telephone_number": "650-587-8574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 ALAMEDA DE LAS PULGAS",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944031222",
            "telephone_number": "650-587-8574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODY",
        "first_name": "ELIZABETH",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G86385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CBHS INTERNAL USE ONLY-COMMERCIAL NUMBER",
            "identifier": "8636",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SFGH INTERNAL USE ONLY",
            "identifier": "8636",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.