Active NPI
Jose Maria Rodriguez-Maldonado, M.D.
- Internal Medicine Physician
- Ridgeland, SC
National Provider Identifier
1255360673
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 01086626A
- Practice address
- 177 Knightsbridge Road
Ridgeland, SC 29936-2605 - Phone
- (843) 987-7400
- Fax
- (843) 987-4798
- NPI assigned
- Jun 30, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 48608 | KY | |
| Emergency Medicine Physician | 207P00000X | 01086626A | IN | |
| Internal Medicine Physician | 207R00000X | 26488 | SC | |
| Internal Medicine Physician | 207R00000X | 48608 | KY | |
| Internal Medicine Physician | 207R00000X | 01086626A | IN | Primary |
Addresses
Primary practice location
177 Knightsbridge Road
Ridgeland, SC 29936-2605
Mailing address
200 Corporate Blvd Ste 105
Lafayette, LA 70508-3870
Phone (800) 893-9698
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 264886 | Medicaid | SC |
Other names 1
- Dr. Jose M Rodriguez
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1141 Hospital Dr NW
Corydon, IN 47112-2164
Phone (812) 738-4251
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TP647 | KY | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clarksville Emergency Group, PC | Emergency Medicine | Current | Accepting new patients |
| Hardeeville Hospitalists, LLC | Past | Accepting new patients |
Locations
1141 Hospital Dr NW
Corydon, IN 47112
Phone (812) 738-7830
1 Trillium Way
Corbin, KY 40701
Phone (606) 523-8521
200 Corporate Blvd
Ste 105
Lafayette, LA 70508
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.
-
- Emergency Medicine Physician
- Corydon, IN
- NPI 1023487154
-
- Hospitalist Physician
- Hardeeville, SC
- NPI 1821365081
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Corydon, IN
- NPI 1427165455
-
- Critical Access Hospital
- Corydon, IN
- NPI 1851378137
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637020800000",
"number": "1255360673",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 CORPORATE BLVD STE 105",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705083870",
"telephone_number": "800-893-9698"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "177 KNIGHTSBRIDGE ROAD",
"city": "RIDGELAND",
"state": "SC",
"postal_code": "299362605",
"telephone_number": "843-987-7400",
"fax_number": "843-987-4798"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ-MALDONADO",
"first_name": "JOSE",
"middle_name": "MARIA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-30",
"last_updated": "2021-11-16",
"certification_date": "2021-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "KY",
"license": "48608",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IN",
"license": "01086626A",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "SC",
"license": "26488",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "KY",
"license": "48608",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IN",
"license": "01086626A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "264886",
"state": "SC"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JOSE",
"last_name": "RODRIGUEZ",
"middle_name": "M",
"prefix": "DR.",
"credential": "MD",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Ridgeland, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2021; 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.