Individual provider Active NPI

Ife Rodney, M.D.

  • Dermatology Physician
  • Fulton, MD
National Provider Identifier
1184895922
Registry record updated Sep 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
D0071033 Issued in MD
Practice address
11711 E Market PL Ste 100
Fulton, MD 20759-2710
Phone
(301) 479-6544
Fax
(240) 654-0408
NPI assigned
Mar 20, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD037018 DC
Dermatology Physician 207N00000X D0071033 MD Primary

Addresses

Primary practice location

11711 E Market PL Ste 100
Fulton, MD 20759-2710

Mailing address

11711 E Market PL Ste 100
Fulton, MD 20759-2710
Phone (301) 479-6544

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 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
I20110930000114 DC Practitioner - Dermatology 6406028109 Reassigns benefits to 1 organization
I20170509000210 MD Practitioner - DermatologyPractitioner - Pathology 6406028109 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
DermatologyAlso: Pathology
Education
Howard University College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11711 E Market PL
Suite 100
Fulton, MD 20759-2710
Phone (301) 679-5772

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision14
Removal of skin lesions200
Removal or shaving of skin growth33
Skin biopsy37

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0071033MDMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bespoke Aesthetic Plastic Surgery CurrentSince Mar 1, 2023 Accepting new patients
Integrated Dermatology Group, LLC Dermatology CurrentSince Jan 1, 2018 Accepting new patients
Eternal Dermatology and Aesthetic Center LLC Dermatology CurrentSince Apr 2, 2018 Accepting new patients
Integrated Dermatology Group, LLC Dermatology CurrentSince Jan 1, 2018 Accepting new patients

Locations

6021 University Blvd
Ste 390
Ellicott City, MD 21043
Phone (410) 203-0607

11711 E Market Pl
Ste 100
Fulton, MD 20759
Phone (301) 479-6544

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/ez_00122

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.

NPI Registry JSON

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

{
    "created_epoch": "1205971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727481600000",
    "number": "1184895922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11711 E MARKET PL STE 100",
            "city": "FULTON",
            "state": "MD",
            "postal_code": "207592710",
            "telephone_number": "301-479-6544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11711 E MARKET PL STE 100",
            "city": "FULTON",
            "state": "MD",
            "postal_code": "207592710",
            "telephone_number": "301-479-6544",
            "fax_number": "240-654-0408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODNEY",
        "first_name": "IFE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-20",
        "last_updated": "2024-09-28",
        "certification_date": "2024-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "DC",
            "license": "MD037018",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MD",
            "license": "D0071033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fulton, MD

Sources for this page

Verify at the official NPI Registry.