Individual provider Active NPI

Daniald M Rodrigues, M.D.

  • Gastroenterology Physician
  • Mission Viejo, CA
National Provider Identifier
1174767230
Registry record updated Nov 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
C164055 Issued in CA
Practice address
27871 Medical Center Rd Ste 200
Mission Viejo, CA 92691-6406
Phone
(949) 364-5090
NPI assigned
Apr 20, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301086424 MI
Gastroenterology Physician 207RG0100X C164055 CA Primary

Addresses

Primary practice location

27871 Medical Center Rd Ste 200
Mission Viejo, CA 92691-6406

Mailing address

27871 Medical Center Rd Ste 200
Mission Viejo, CA 92691-6406
Phone (949) 364-5090

Other practice location 1

4100 Lake Dr SE
Ste. 205
Grand Rapids, MI 49546-8292
Phone (616) 267-7414

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address drodrigues1374072@oc.providencedirect.org

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200109003008 CA Practitioner - Gastroenterology 7911178538 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Wayne State University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

1950 Sunny Crest Dr
Suite 2900
Fullerton, CA 92835-3641
Phone (714) 992-5350

27700 Medical Ctr Rd
Mission Viejo, CA 92691-6426
Phone (949) 364-1400

27799 Medical Ctr Rd
Mission Viejo, CA 92691-6400

Hospital & facility affiliations

  • Providence Mission Hospital Hospital, Mission Viejo, CA, CCN 050567

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy77
Upper gastrointestinal (GI) endoscopy for acid reflux105

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C164055CAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince Dec 23, 2019 Accepting new patients
Providence Medical Foundation Current Accepting new patients
Mission Hospital Regional Medical Center Past Accepting new patients
Providence Medical Foundation Past Accepting new patients

Locations

200 W Ctr St Promenade
Ste 300
Anaheim, CA 92805
Phone (714) 449-4841

100 E Valencia Mesa Dr
#1051182
Fullerton, CA 92835
Phone (714) 446-5200

100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

27799 Medical Center Rd
Ste 310
Mission Viejo, CA 92691
Phone (949) 364-5090

26800 Crown Valley Pkwy
Ste 300
Mission Viejo, CA 92691

27871 Medical Center Rd
Ste 200
Mission Viejo, CA 92691
Phone (949) 347-8314

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: drodrigues1374072@oc.providencedirect.org

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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": "1240185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1174767230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27871 MEDICAL CENTER RD STE 200",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916406",
            "telephone_number": "949-364-5090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27871 MEDICAL CENTER RD STE 200",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916406",
            "telephone_number": "949-364-5090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4100 Lake Dr SE",
            "address_2": "Ste. 205",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495468292",
            "country_code": "US",
            "telephone_number": "616-267-7414",
            "fax_number": "616-267-7137",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUES",
        "first_name": "DANIALD",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-20",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301086424",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "C164055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drodrigues1374072@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "27799 Medical Center Rd Ste 310",
            "city": "Mission Viejo",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926916400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

Verify at the official NPI Registry.