Carlos Rodriguez, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

52164 Issued in CA

Practice address

316 25TH St
San Diego, CA 92102-3016

Phone

(619) 445-6200

NPI assigned

Nov 18, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Somagen Healthcare Inc

  • Urgent Care Clinic/Center
  • San Diego, CA
  • NPI 1558788620
  NPD
• Somagen Healthcare Inc

  • Urgent Care Clinic/Center
  • Santee, CA
  • NPI 1396058137
  NPD (past)

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

{
    "created_epoch": "1416268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416268800000",
    "number": "1174929194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 25TH ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921023016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 25TH ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921023016",
            "telephone_number": "619-445-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "CARLOS",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-11-18",
        "last_updated": "2014-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "52164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenda Rodriguez
• Brian Rodriguez
• Caitlin Rodriguez
• Camryn Julien Stevahn Rodriguez, IDC
• Carla Rodriguez
• Carmen Rodriguez, SA-C
• Carmen Ballestero Rodriguez, R.N.
• Carolyn Lababit Rodriguez, RT(R)
• Carolyn Plou Rodriguez, PT, DPT
• Casandra Rodriguez

• Physician Assistant in San Diego, CA
• Providers in San Diego, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.