NPIMap

Individual provider Active NPI

Kristin M Rodriguez, DO

  • Emergency Medicine Physician
  • Placentia, CA
National Provider Identifier
1205880598
Registry record updated Feb 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OP61224612 Issued in WA
Practice address
1301 Rose Drive
Placentia, CA 92870
Phone
(714) 993-2000
NPI assigned
May 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 20A6961 CA
Emergency Medicine Physician 207P00000X OP61224612 WA Primary

Addresses

Primary practice location

1301 Rose Drive
Placentia, CA 92870

Mailing address

PO Box 10279
Westminster, CA 92685-0279
Phone (562) 809-3545

Other identifiers 1

IdentifierTypeStateIssuer
00AX69610MedicaidCA

Other names 1

  • Kristin M Hanson Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A6961CAMDEmergency Medicine Physician
OP61224612WAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Glass Beach Medical Services a Medical Corporation Emergency Medicine Past Accepting new patients
Acute Care Medical Group of Orange Inc Emergency Medicine Past Accepting new patients
Dr Kristin Rodriguez Medical Corporation Emergency Medicine PastSince Mar 1, 2006 Accepting new patients

Organizations & group practices 3

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": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677110400000",
    "number": "1205880598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10279",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926850279",
            "telephone_number": "562-809-3545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 ROSE DRIVE",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "92870",
            "telephone_number": "714-993-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "KRISTIN",
        "middle_name": "M",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-20",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20A6961",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "OP61224612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX69610",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "HANSON",
            "middle_name": "M",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Placentia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.