Active NPI
Jane Ellen Rodgers
- Physician Assistant
- Pomona, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA15940
- Practice address
- 790 E Bonita Ave FL 2
Pomona, CA 91767-1906 - Phone
- (909) 447-8585
- Fax
- (909) 447-8593
- NPI assigned
- Apr 8, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA15940 | CA | Primary |
Addresses
Primary practice location
790 E Bonita Ave FL 2
Pomona, CA 91767-1906
Mailing address
7300 Ranch Road 2222, Building 1, Ste 200
Austin, TX 78730
Phone (512) 628-0465
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA, AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
530 N Estrella Pkwy
Suite C1
Goodyear, AZ 85338-4138
Phone (623) 932-9211
Merit-based Incentive Payment System (MIPS)
- Final score
- 82.18 of 100
- Quality
- 65.23
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.35
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9154 | AZ | MD | Dentist |
| PA15940 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chaparral Medical Group Inc. | Current | Accepting new patients | |
| Chaparral Medical Group, Inc. | Current | Accepting new patients | |
| Chaparral Medical Group Inc. | Current | Accepting new patients | |
| Pkwy Medical Center LLC | Past | Accepting new patients | |
| Epiphany Dermatology PA | Past | Accepting new patients |
Locations
1801 W Olympic Blvd
Pasadena, CA 91199
840 Towne Center Dr
Pomona, CA 91767
790 E Bonita Ave
Fl 2
Pomona, CA 91767
Phone (909) 447-8585
1866 N Orange Grove Ave
Ste 202
Pomona, CA 91767
Phone (909) 623-8796
9190 Haven Ave
Ste 101
Rancho Cucamonga, CA 91730
Phone (909) 581-6732
585 N Mountain Ave
Ste A
Upland, CA 91786
Phone (909) 608-7546
Interoperability endpoints
- jane.rodgers@epiphanyderm.emadirect.md
Organizations & group practices 11
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.
-
- Medical Physician Assistant
- Goodyear, AZ
- NPI 1871546036
-
- Dermatology Physician
- Rancho Cucamonga, CA
- NPI 1093777666
-
- Orthopaedic Surgery Physician
- Pomona, CA
- NPI 1477733624
-
- Plastic Surgery Physician
- Palm Desert, CA
- NPI 1356770515
-
- Dermatology Physician
- Peoria, AZ
- NPI 1457465858
-
- Sports Medicine (Neuromusculoskeletal Medicine) Physician
- Sun City West, AZ
- NPI 1760262539
-
- Cardiovascular Disease Physician
- Upland, CA
- NPI 1639869605
-
- Gastroenterology Physician
- Upland, CA
- NPI 1780146019
-
- Otolaryngology Physician
- Pomona, CA
- NPI 1134508955
-
- Dermatology Physician
- Waco, TX
- NPI 1043615263
-
- General Practice Physician
- Goodyear, AZ
- NPI 1588158349
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1239148800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679270400000",
"number": "1235372145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7300 RANCH ROAD 2222, BUILDING 1, STE 200",
"city": "AUSTIN",
"state": "TX",
"postal_code": "78730",
"telephone_number": "512-628-0465"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "790 E BONITA AVE FL 2",
"city": "POMONA",
"state": "CA",
"postal_code": "917671906",
"telephone_number": "909-447-8585",
"fax_number": "909-447-8593"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODGERS",
"first_name": "JANE",
"middle_name": "ELLEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-04-08",
"last_updated": "2023-03-20",
"certification_date": "2023-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA15940",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Pomona, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.