Rodrick L. Meraz, PA

Key facts

NPI

1235148289

Entity type

Individual (NPI type 1)

Primary specialty

Medical Physician Assistant 363AM0700X

License

PA12560 (CA)

Practice address

11919 Hesperia Rd
Hesperia, CA 92345-2158

Phone

(760) 948-1454

Fax

(760) 948-6100

NPI assigned

Aug 7, 2006

Sex

Male

Sole proprietor

No

Organizations & group practices 2

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.

• Privia Medical Group Arizona, LLC Family Medicine Physician · Phoenix, AZ · NPI 1760441141
  NPD (past)
• Total Orthopedics,LLC Specialist · Glendale, AZ · NPI 1326302472
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: rodrick.meraz.p4@direct.fpa.nextgenshare.com

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 21, 2016.

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479686400000",
    "number": "1235148289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11919 HESPERIA RD",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "923452158",
            "telephone_number": "760-948-1454",
            "fax_number": "760-948-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11919 HESPERIA RD",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "923452158",
            "telephone_number": "760-948-1454",
            "fax_number": "760-948-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERAZ",
        "first_name": "RODRICK",
        "middle_name": "L.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2016-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146D00000X",
            "taxonomy_group": "",
            "desc": "Personal Emergency Response Attendant",
            "state": "CA",
            "license": "PA12560",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "3589",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA12560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Hesperia, CA · Medical Physician Assistant in California