Individual provider Active NPI

Ronald Armando Rodriguez, PA-C

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1275739724
Registry record updated Jan 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-02449 Issued in NC
Practice address
2630 E. 7TH Street
Suite 200
Charlotte, NC 28204-4319
Phone
(704) 364-6110
Fax
(704) 364-4245
NPI assigned
Jun 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110002419 VA
Physician Assistant 363A00000X 0010-02449 NC Primary

Addresses

Primary practice location

2630 E. 7TH Street
Suite 200
Charlotte, NC 28204-4319

Mailing address

2630 E. 7TH Street
Suite 200
Charlotte, NC 28204-4319
Phone (704) 364-6110

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101220000475 NC Practitioner - Physician Assistant 5991899213 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metrolina Dermatology and Skin Surgery Specialists PLLCGroup PAC ID 3173891892, 39 clinicians

Practice addresses (Care Compare)

10502 Park Rd
Suite 100
Charlotte, NC 28210-6569
Phone (980) 299-3926

11840 Southmore Dr
Suite 170
Charlotte, NC 28277-0792
Phone (704) 364-6110

1238 Mann Dr
Matthews, NC 28105-5539
Phone (704) 364-6110

9550 Rocky River Rd
Suite 200
Charlotte, NC 28215-9526
Phone (704) 364-6110

Merit-based Incentive Payment System (MIPS)

Final score
84.08 of 100Reported as group
Quality
81.28
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-02449NCMDPhysician Assistant
0110002419VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Charlotte Dermatology,PA CurrentSince Nov 1, 2010 Accepting new patients

Locations

2630 E 7th St
Ste 200
Charlotte, NC 28204
Phone (704) 927-6166

9550 Rocky River Rd
Ste 200
Charlotte, NC 28215

11840 Southmore Dr
Ste 170
Charlotte, NC 28277

1238 Mann Dr
Matthews, NC 28105
Phone (704) 771-1714

Interoperability endpoints

  • Direct secure messaging: ron2@charlottederm.emadirect.md

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674777600000",
    "number": "1275739724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2630 E. 7TH STREET",
            "address_2": "SUITE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282044319",
            "telephone_number": "704-364-6110",
            "fax_number": "704-364-4245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2630 E. 7TH STREET",
            "address_2": "SUITE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282044319",
            "telephone_number": "704-364-6110",
            "fax_number": "704-364-4245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "RONALD",
        "middle_name": "ARMANDO",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-22",
        "last_updated": "2023-01-27",
        "certification_date": "2023-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110002419",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-02449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.