Active NPI
Benito B Rodriguez, PA C
- Physician Assistant
- Sun City West, AZ
National Provider Identifier
1124064183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 3813
- Practice address
- 14502 W Meeker Blvd
Sun City West, AZ 85375-5282 - Phone
- (623) 214-4000
- Fax
- (623) 214-4000
- NPI assigned
- Jun 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 232 | MT | |
| Physician Assistant | 363A00000X | 3813 | AZ | Primary |
Addresses
Primary practice location
14502 W Meeker Blvd
Sun City West, AZ 85375-5282
Mailing address
2100 Powell St Ste 400
Emeryville, CA 94608-1826
Phone (510) 350-2600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0435506 | Medicaid | MT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 85.77 of 100
- Quality
- 81.6
- Improvement activities
- 40
- Cost
- 77.61
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 232 | MT | MD | Clinical Neuropsychologist |
| 3813 | AZ | MD | Physician Assistant |
Organizations & group practices 1
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.
-
- Emergency Medicine Physician
- Chandler, AZ
- NPI 1780202804
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571097600000",
"number": "1124064183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2100 POWELL ST STE 400",
"city": "EMERYVILLE",
"state": "CA",
"postal_code": "946081826",
"telephone_number": "510-350-2600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14502 W MEEKER BLVD",
"city": "SUN CITY WEST",
"state": "AZ",
"postal_code": "853755282",
"telephone_number": "623-214-4000",
"fax_number": "623-214-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "BENITO",
"middle_name": "B",
"credential": "PA C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-20",
"last_updated": "2019-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "MT",
"license": "232",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AZ",
"license": "3813",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0435506",
"state": "MT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Sun City West, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2019; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.