Individual provider Active NPI

Sarah June Rodriguez, M.D.

  • Family Medicine Physician
  • Grand Rapids, MI
National Provider Identifier
1194089672
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301100769 Issued in MI
Practice address
1471 E Beltline Ave NE Ste 201
Grand Rapids, MI 49525-4548
Phone
(616) 685-8620
Fax
(616) 447-7674
NPI assigned
Jun 28, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301100769 MI Primary

Addresses

Primary practice location

1471 E Beltline Ave NE Ste 201
Grand Rapids, MI 49525-4548

Mailing address

450 Fountain St NE
Apt. 3
Grand Rapids, MI 49503-5605
Phone (734) 846-3296

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20150710001112 MI Practitioner - Family Practice 4981848850 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Human Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advantage Health/Saint Mary'S Medical GroupGroup PAC ID 4082807961, 499 clinicians

Practice addresses (Care Compare)

1471 E Beltline Ave NE
201 Trinity Health Med Group
Grand Rapids, MI 49525-4548
Phone (616) 685-8620

Hospital & facility affiliations

  • Mercy Health Saint Mary'S Hospital, Grand Rapids, MI, CCN 230059
  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Health Saint Mary'S Medical Group CurrentSince Sep 1, 2015 Accepting new patients
Advantage Health Saint Mary'S Medical Group CurrentSince Sep 1, 2015 Accepting new patients
Advantage Health/Saint Mary'S Medical Group Current Accepting new patients
Saint Mary'S Health Services Past Accepting new patients

Locations

10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850

1471 E Beltline Ave NE
Ste 201
Grand Rapids, MI 49525
Phone (616) 685-8620

475 S State St
Sparta, MI 49345
Phone (616) 685-1300

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 3

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": "1340841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1194089672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 FOUNTAIN ST NE",
            "address_2": "APT. 3",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495035605",
            "telephone_number": "734-846-3296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1471 E BELTLINE AVE NE STE 201",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495254548",
            "telephone_number": "616-685-8620",
            "fax_number": "616-447-7674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "SARAH",
        "middle_name": "JUNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-28",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301100769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.