Individual provider Active NPI

Nitza Ninoska Rodriguez, DPM

  • Foot & Ankle Surgery Podiatrist
  • Ladera Ranch, CA
National Provider Identifier
1265581540
Registry record updated Feb 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E4790 Issued in CA
Practice address
333 Corporate Dr Ste 230
Ladera Ranch, CA 92694-2180
Phone
(949) 364-9255
Fax
(949) 364-9250
NPI assigned
Jan 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X E4790 CA Primary

Addresses

Primary practice location

333 Corporate Dr Ste 230
Ladera Ranch, CA 92694-2180

Mailing address

27800 Medical Center Rd
Suite 110
Mission Viejo, CA 92691-6407
Phone (949) 364-9255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120328000911 CA Practitioner - Podiatry 3870753841 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spencer Rodriguez Podiatry CorporationGroup PAC ID 9739305061, 3 clinicians

Practice addresses (Care Compare)

333 Corporate Dr
Suite 230
Ladera Ranch, CA 92694-2180
Phone (949) 364-9255

Merit-based Incentive Payment System (MIPS)

Final score
72.4 of 100Reported as group
Quality
44.81
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue17
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E4790CAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Spencer Rodriguez Podiatry Corporation Foot & Ankle Surgery CurrentSince Jun 1, 2014 Accepting new patients
Spencer Rodriguez Podiatry Corporation Foot & Ankle Surgery CurrentSince Jun 1, 2014 Accepting new patients
Saddleback Memorial Medical Center Past Accepting new patients
White Memorial Medical Center Past Accepting new patients

Locations

333 Corporate Dr
Ste 230
Ladera Ranch, CA 92694
Phone (949) 364-9255

27800 Medical Center Rd
Ste 110
Mission Viejo, CA 92691
Phone (949) 364-9255

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582156800000",
    "number": "1265581540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27800 MEDICAL CENTER RD",
            "address_2": "SUITE 110",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916407",
            "telephone_number": "949-364-9255",
            "fax_number": "949-364-9250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 CORPORATE DR STE 230",
            "city": "LADERA RANCH",
            "state": "CA",
            "postal_code": "926942180",
            "telephone_number": "949-364-9255",
            "fax_number": "949-364-9250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "NITZA",
        "middle_name": "NINOSKA",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E4790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ladera Ranch, CA

Sources for this page

Verify at the official NPI Registry.