Individual provider Active NPI

Carlos A Rodriguez, M.D.

  • Gastroenterology Physician
  • Bakersfield, CA
National Provider Identifier
1164420840
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
G138158 Issued in CA
Practice address
3700 Mall View Rd
Bakersfield, CA 93306-3050
Phone
(877) 524-7373
NPI assigned
Jul 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 45942 AZ
Gastroenterology Physician 207RG0100X 036082812 IL
Gastroenterology Physician 207RG0100X G138158 CA Primary

Addresses

Primary practice location

3700 Mall View Rd
Bakersfield, CA 93306-3050

Mailing address

3700 Mall View Rd
Bakersfield, CA 93306-3050
Phone (877) 524-7373

Other identifiers 2

IdentifierTypeStateIssuer
203529OtherILMEDICARE GROUP
36082812MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070207000218 IL Practitioner - GastroenterologyPractitioner - Internal Medicine 3173415643 Reassigns benefits to 1 organization
I20151110000605 CA Practitioner - Internal MedicinePractitioner - Gastroenterology 3173415643 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
45942AZMDGastroenterology Physician
G138158CAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois Gastroenterology Group, LLC Gastroenterology CurrentSince Nov 1, 2013 Accepting new patients
Northwest Gastroenterologists SC Current Accepting new patients
Elgin Gastroenterology Endoscopy Center LLC Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Oct 5, 2015 Accepting new patients
Elgin Gastroenterology SC Gastroenterology Current Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Oct 5, 2015 Accepting new patients

Locations

3700 Mall View Rd
Bakersfield, CA 93306
Phone (661) 334-2940

3733 San Dimas St
Bakersfield, CA 93301
Phone (661) 631-3008

3733 San Dimas St
Ste 101
Bakersfield, CA 93301
Phone (800) 353-5400

393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914

1 Kish Hospital Dr
DeKalb, IL 60115
Phone (815) 754-1521

745 Fletcher Dr
Ste 202
Elgin, IL 60123
Phone (855) 483-7362

302 Randall Rd
Ste 308
Geneva, IL 60134
Phone (630) 208-7388

2550 W Algonquin Rd
Lk in the Hls, IL 60156
Phone (847) 458-1246

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1164420840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 MALL VIEW RD",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933063050",
            "telephone_number": "877-524-7373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 MALL VIEW RD",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933063050",
            "telephone_number": "877-524-7373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "CARLOS",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "AZ",
            "license": "45942",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036082812",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "G138158",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "203529",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36082812",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "3733 San Dimas St",
            "city": "Bakersfield",
            "state": "CA",
            "country_code": "US",
            "postal_code": "933011407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

Verify at the official NPI Registry.