Individual provider Active NPI

Victor M. Rodriguez, MD

  • Surgery Physician
  • Sacramento, CA
National Provider Identifier
1114005873
Registry record updated Mar 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
AFE85512 Issued in CA
Practice address
2800 L St Ste 600
Sacramento, CA 95816-5616
Phone
(916) 454-6850
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2022

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

Specialties & licenses 12

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD60488619 WA
Surgery Physician 208600000X MD166937 OR
Surgery Physician 208600000X A65512 CA
Vascular Surgery Physician 2086S0129X MD60488619 WA
Vascular Surgery Physician 2086S0129X AFE65512 CA
Vascular Surgery Physician 2086S0129X MD166937 OR
Vascular Surgery Physician 2086S0129X A65512 CA
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X MD60488619 WA
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X MD166937 OR
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X AFE65512 CA
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X A65512 CA
Surgery Physician 208600000X AFE85512 CA Primary

Addresses

Primary practice location

2800 L St Ste 600
Sacramento, CA 95816-5616

Mailing address

PO Box 255228
Sacramento, CA 95865-5228

Other identifiers 1

IdentifierTypeStateIssuer
500670555MedicaidOR

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
I20031218000523 CA Practitioner - Cardiac SurgeryPractitioner - Thoracic SurgeryPractitioner - General SurgeryPractitioner - Vascular SurgeryPractitioner - Peripheral Vascular Disease 2769389519 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiac SurgeryAlso: General Surgery, Peripheral Vascular Disease, Thoracic Surgery, Vascular Surgery
Education
University of California, Davis School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

2800 L St
Sacramento, CA 95816-5616

2825 Capitol Ave
Sacramento, CA 95816-6039
Phone (916) 454-6600

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)58
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A65512CAMDSurgery Physician
AFE85512CAMDSurgery Physician
MD60488619WAMDVascular Surgery Physician
AFE65512CAMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation Current Accepting new patients
Sutter Valley Medical Foundation Surgery CurrentSince Mar 14, 2022 Accepting new patients
Regents of the Univ of Ca CurrentSince Jul 17, 2017 Accepting new patients
Regents of the University of Ca CurrentSince Jul 17, 2017 Accepting new patients
Sutter Valley Medical Foundation CurrentSince Mar 14, 2022 Accepting new patients
Regents of the Univ of Ca Current Accepting new patients
Oregon Health & Science University Past Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Sutter North Medical Foundation Past Accepting new patients

Locations

643 W East Ave
Chico, CA 95926
Phone (530) 342-0502

2720 Low Ct
Fairfield, CA 94534
Phone (707) 428-2731

500 W Hospital Rd
French Camp, CA 95231
Phone (209) 468-6000

815 Court St
Ste 7
Jackson, CA 95642
Phone (209) 257-5900

600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755

2767 Olive Hwy
Oroville, CA 95966
Phone (916) 533-8500

801 E St
Patterson, CA 95363
Phone (209) 521-2024

2221 Stockton Blvd
Sacramento, CA 95817
Phone (916) 734-2680

2221 Stockton Blvd
Rm 3104
Sacramento, CA 95817

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

2221 Stockton Blvd
Ste E
Sacramento, CA 95817
Phone (916) 734-2680

4860 Y St
Sacramento, CA 95817
Phone (916) 734-2700

Interoperability endpoints

  • Direct secure messaging: vrodriguez386468@hisp.ehr.sutterhealth.org
  • Direct secure messaging: vrodriguez86888@direct.ohsu.edu

Organizations & group practices 9

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.

Hospital & facility affiliations 5

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646092800000",
    "number": "1114005873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 255228",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958655228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 L ST STE 600",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165616",
            "telephone_number": "916-454-6850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "VICTOR",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD60488619",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OR",
            "license": "MD166937",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A65512",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "WA",
            "license": "MD60488619",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "AFE65512",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "OR",
            "license": "MD166937",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "A65512",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "WA",
            "license": "MD60488619",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "OR",
            "license": "MD166937",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "CA",
            "license": "AFE65512",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "CA",
            "license": "A65512",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "AFE85512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500670555",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.