Individual provider Active NPI

Ellenbeth Grossnickle Rodarte, M.D.

  • Family Medicine Physician
  • Del Mar, CA
National Provider Identifier
1205808714
Registry record updated Jun 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A76932 Issued in CA
Practice address
2600 Via de la Valle
Ste 200
Del Mar, CA 92014-1992
Phone
(858) 499-2708
Fax
(858) 309-3269
NPI assigned
Feb 7, 2006
Last updated
Jun 6, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2014

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 A76932 CA Primary

Addresses

Primary practice location

2600 Via de la Valle
Ste 200
Del Mar, CA 92014-1992

Mailing address

2600 Via de la Valle
Ste 200
Del Mar, CA 92014-1992
Phone (858) 499-2708

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
I20050304000291 CA Practitioner - Family Practice 8325092158 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, San Francisco School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sharp Rees-Stealy Medical Group IncGroup PAC ID 8628972759, 872 clinicians

Practice addresses (Care Compare)

10670 Wexford St
San Diego, CA 92131-3940
Phone (858) 621-4002

2600 Via de la Valle
Suite 200
Del Mar, CA 92014-1992
Phone (858) 499-2600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.67 of 100Reported as group
Quality
81.04
Promoting interoperability
99
Improvement activities
40
Cost
82.04

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A76932CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Feb 13, 2014 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc Family Medicine CurrentSince Feb 13, 2014 Accepting new patients
Sharp Memorial Hospital Past Accepting new patients
Sharp Rees-Stealy Medical Center Past Accepting new patients
Sharp Memorial Hospital Past Accepting new patients
Tricare Outpatient Clinic Clairemont Past Accepting new patients

Locations

2600 Via de la Valle
Ste 200
Del Mar, CA 92014
Phone (858) 309-3160

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

5651 Copley Dr
San Diego, CA 92111
Phone (858) 262-6340

Interoperability endpoints

  • Direct secure messaging: erodarte32982@sharphealthcare.direct-ci.com

Organizations & group practices 6

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.

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": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402012800000",
    "number": "1205808714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 VIA DE LA VALLE",
            "address_2": "STE 200",
            "city": "DEL MAR",
            "state": "CA",
            "postal_code": "920141992",
            "telephone_number": "858-499-2708",
            "fax_number": "858-309-3269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 VIA DE LA VALLE",
            "address_2": "STE 200",
            "city": "DEL MAR",
            "state": "CA",
            "postal_code": "920141992",
            "telephone_number": "858-499-2708",
            "fax_number": "858-309-3269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODARTE",
        "first_name": "ELLENBETH",
        "middle_name": "GROSSNICKLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-07",
        "last_updated": "2014-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A76932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Del Mar, CA

Sources for this page

Verify at the official NPI Registry.