Individual provider Active NPI

Carina S Rodelo, PA-C

  • Physician Assistant
  • Ventura, CA
National Provider Identifier
1164171856
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
61368 Issued in CA
Practice address
168 N Brent St Ste 502
Ventura, CA 93003-2840
Phone
(805) 641-2000
Fax
(805) 653-1644
NPI assigned
Mar 21, 2022
Last updated
Jun 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 61368 CA Primary

Addresses

Primary practice location

168 N Brent St Ste 502
Ventura, CA 93003-2840

Mailing address

3400 Data Dr
Rancho Cordova, CA 95670-7956
Phone (916) 851-2462

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240507004198 CA Practitioner - Physician Assistant 3072954122 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Yale University School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dignity Health Medical FoundationGroup PAC ID 7810800661, 1,211 clinicians

Practice addresses (Care Compare)

1700 N Rose Ave
Suite 350
Oxnard, CA 93030-7627
Phone (805) 485-7877

2901 N Ventura Rd
Suite 100
Oxnard, CA 93036-1126
Phone (805) 981-6101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
61368CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Medical Foundation CurrentSince May 26, 2024 Accepting new patients
Dignity Health Medical Foundation CurrentSince May 26, 2024 Accepting new patients

Locations

1700 N Rose Ave
Ste 350
Oxnard, CA 93030
Phone (805) 485-7877

2901 N Ventura Rd
Ste 100
Oxnard, CA 93036
Phone (805) 981-6101

3400 Data Dr
Rncho Cordova, CA 95670
Phone (916) 379-2726

168 N Brent St
Ste 502
Ventura, CA 93003
Phone (805) 641-2000

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1647820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1164171856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956",
            "telephone_number": "916-851-2462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "168 N BRENT ST STE 502",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930032840",
            "telephone_number": "805-641-2000",
            "fax_number": "805-653-1644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODELO",
        "first_name": "CARINA",
        "middle_name": "S",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-21",
        "last_updated": "2024-06-04",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "61368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.