NPIMap

Individual provider Active NPI

Maria R Rodebaugh, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Coeur d'Alene, ID
National Provider Identifier
1114961190
Registry record updated Jul 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
M11187 Issued in ID
Practice address
1919 Lincoln Way
211
Coeur D Alene, ID 83814-2527
Phone
(208) 625-5500
Fax
(208) 625-5501
NPI assigned
Jun 16, 2006
Last updated
Jul 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X M11187 ID Primary

Addresses

Primary practice location

1919 Lincoln Way
211
Coeur D Alene, ID 83814-2527

Mailing address

2003 Kootenai Health Way
Coeur D' Alene, ID 83814
Phone (208) 625-4000

Other identifiers 1

IdentifierTypeStateIssuer
117833400MedicaidWY

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address maria.rodebaugh.p79@direct.kootenai.nextgenshare.com
Direct Messaging Address mrodebaugh610873@direct.multicare.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110610000167 ID Practitioner - Endocrinology 0941362180 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kootenai Health IncGroup PAC ID 1355792276, 394 clinicians

Practice addresses (Care Compare)

1055 Riverside Ave
Orofino, ID 83544-9029
Phone (208) 476-5777

1919 Lincoln Way
Coeur D Alene, ID 83814-2527

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.65 of 100Reported as apm
Quality
89.26
Promoting interoperability
69.9
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M11187IDMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kootenai Health, Inc. CurrentSince Jul 1, 2011 Accepting new patients
Kootenai Health, Inc. Current Accepting new patients
Kootenai Health, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Incyte Pathology, PLLC Current Accepting new patients
Kootenai Health, Inc. CurrentSince Jul 1, 2011 Accepting new patients
Wong & Litchfield, LTD Endocrinology, Diabetes & Metabolism Past Accepting new patients

Locations

1919 Lincoln Way
Ste 211
Coeur D Alene, ID 83814
Phone (208) 625-4700

2003 Kootenai Health Way
Coeur D Alene, ID 83814
Phone (208) 625-5085

1300 E Mullan Ave
Ste 700
Post Falls, ID 83854
Phone (208) 625-5564

Interoperability endpoints

  • Direct secure messaging: maria.rodebaugh.p79@direct.kootenai.nextgenshare.com
  • Direct secure messaging: mrodebaugh610873@direct.multicare.org

Organizations & group practices 6

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 6

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": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753142400000",
    "number": "1114961190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2003 KOOTENAI HEALTH WAY",
            "city": "COEUR D' ALENE",
            "state": "ID",
            "postal_code": "83814",
            "telephone_number": "208-625-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 LINCOLN WAY",
            "address_2": "211",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142527",
            "telephone_number": "208-625-5500",
            "fax_number": "208-625-5501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODEBAUGH",
        "first_name": "MARIA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "ID",
            "license": "M11187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117833400",
            "state": "WY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "maria.rodebaugh.p79@direct.kootenai.nextgenshare.com",
            "affiliation": "N",
            "address_1": "1919 Lincoln Way",
            "address_2": "211",
            "city": "Coeur D Alene",
            "state": "ID",
            "country_code": "US",
            "postal_code": "838142527",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mrodebaugh610873@direct.multicare.org",
            "affiliation": "N",
            "address_1": "1919 Lincoln Way",
            "address_2": "211",
            "city": "Coeur D Alene",
            "state": "ID",
            "country_code": "US",
            "postal_code": "838142527",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Coeur d'Alene, ID

Sources for this page

Verify at the official NPI Registry.