NPIMap

Individual provider Active NPI

Roderick Claybrooks, MD

  • Orthopaedic Surgery of the Spine Physician
  • Southfield, MI
National Provider Identifier
1255325684
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
4301074231 Issued in MI
Practice address
22250 Providence Dr
Suite 601
Southfield, MI 48075-4825
Phone
(248) 569-7745
Fax
(248) 569-4539
NPI assigned
Aug 31, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine Physician 207XS0117X 4301074231 MI Primary

Addresses

Primary practice location

22250 Providence Dr
Suite 601
Southfield, MI 48075-4825

Mailing address

22250 Providence Dr
Suite 601
Southfield, MI 48075-4825
Phone (248) 569-7745

Other identifiers 13

IdentifierTypeStateIssuer
P00271654OtherMIRDMC
7542611OtherMIAETNA
12897OtherMICAPE
607926000OtherMIOCWP
17348OtherMIMCARE
4781570MedicaidMI
59938OtherMIOMNICARE
024520OtherMIMIDWEST
150941OtherMIGREAT LAKES
141817OtherMICARE CHOICES
RC074231OtherMIBCBS
TAX I.D.OtherMI20-0440211
630511OtherMIBLUE CROSS NETWORK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180217000074 FL Practitioner - Orthopedic Surgery 5890761175 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Wayne State University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cora Health Services IncGroup PAC ID 1759290992, shared by 21 NPIs, 1,125 clinicians
Ability Health Services, IncGroup PAC ID 4082523329, 1,249 clinicians
Ability Health Services and Rehabilitation LPGroup PAC ID 4981986288, shared by 2 NPIs, 1,260 clinicians
Gulfcoast Spine Institute, LLCGroup PAC ID 0749226215, 10 clinicians

Practice addresses (Care Compare)

1050 Old Camp Rd
The Villages, FL 32162-1762
Phone (352) 693-3378

1200 Lexington Green LN
Sanford, FL 32771-1013

2953 Traverse TRL
The Villages, FL 32163-2017
Phone (352) 693-3378

4211 W Boy Scout Blvd
Suite 400 Biopsine Tampa
Tampa, FL 33607-5766
Phone (813) 443-2108

5036 SE 110TH St
Belleview, FL 34420-3759
Phone (352) 693-3378

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion202
Laminectomy or laminotomy (partial removal of spine bones)130

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301074231MIMDOrthopaedic Surgery of the Spine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gulfcoast Spine Institute, LLC Orthopaedic Surgery of the Spine CurrentSince Jan 1, 2018 Accepting new patients
Gulfcoast Spine Institute, LLC Orthopaedic Surgery of the Spine CurrentSince Jan 1, 2018 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

2300 E Norvell Bryant Hwy
Hernando, FL 34442
Phone (352) 341-4778

3900 Millenia Blvd
Orlando, FL 32839
Phone (407) 449-8620

3900 Millenia Blvd
Ste 100
Orlando, FL 32839

7101 Mariner Blvd
Spring Hill, FL 34609
Phone (352) 341-4778

4211 W Boy Scout Blvd
Ste 400
Tampa, FL 33607
Phone (813) 443-2108

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255325684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22250 PROVIDENCE DR",
            "address_2": "SUITE 601",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754825",
            "telephone_number": "248-569-7745",
            "fax_number": "248-569-4539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22250 PROVIDENCE DR",
            "address_2": "SUITE 601",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754825",
            "telephone_number": "248-569-7745",
            "fax_number": "248-569-4539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAYBROOKS",
        "first_name": "RODERICK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "MI",
            "license": "4301074231",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RDMC",
            "identifier": "P00271654",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7542611",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPE",
            "identifier": "12897",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OCWP",
            "identifier": "607926000",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCARE",
            "identifier": "17348",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4781570",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OMNICARE",
            "identifier": "59938",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDWEST",
            "identifier": "024520",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT LAKES",
            "identifier": "150941",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE CHOICES",
            "identifier": "141817",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "RC074231",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "20-0440211",
            "identifier": "TAX I.D.",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS NETWORK",
            "identifier": "630511",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.