Active NPI
Rodolfo Luis Zea, PH.D.
- Psychologist
- Fallston, MD
National Provider Identifier
1174566947
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 01263
- Practice address
- 2101 Lamar CT
Fallston, MD 21047-1821 - Phone
- (410) 893-5669
- NPI assigned
- Jun 13, 2006
- Last updated
- Mar 10, 2008
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 01263 | MD | Primary |
Addresses
Primary practice location
2101 Lamar CT
Fallston, MD 21047-1821
Mailing address
2101 Lamar CT
Fallston, MD 21047-1821
Phone (410) 893-5669
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6100130 | Other | MD | EVERCARE |
| 60484701 | Other | MD | BLUE CROSS BLUE SHIELD |
| G3960012 | Other | DC | BC/BS NATIONAL CAPITAL |
Other names 1
- Dr. Rudy Luis Zea
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1263 | MD | MD | Pastoral Counselor |
| 01263 | MD | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Audiovisual Healthcare Services LLC | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinical Psychologist
- Fairfax, VA
- NPI 1215187281
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205107200000",
"number": "1174566947",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2101 LAMAR CT",
"city": "FALLSTON",
"state": "MD",
"postal_code": "210471821",
"telephone_number": "410-893-5669"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2101 LAMAR CT",
"city": "FALLSTON",
"state": "MD",
"postal_code": "210471821",
"telephone_number": "410-893-5669"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZEA",
"first_name": "RODOLFO",
"middle_name": "LUIS",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-13",
"last_updated": "2008-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MD",
"license": "01263",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EVERCARE",
"identifier": "6100130",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "60484701",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS NATIONAL CAPITAL",
"identifier": "G3960012",
"state": "DC"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "RUDY",
"last_name": "ZEA",
"middle_name": "LUIS",
"prefix": "DR.",
"credential": "PH.D.",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Fallston, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.