Craig Allen Rodriguez, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

12256467-1206 Issued in UT

Practice address

861 N Main St
Richfield, UT 84701-1840

Phone

(435) 558-7031

Fax

(702) 576-9609

NPI assigned

Dec 12, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

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

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Central Utah Dermatology 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Central Utah Dermatology

  • Dermatology Physician
  • Richfield, UT
  • NPI 1245863893

  UT

  Medicare reassignment Care Compare group
• Cedar Dermatology PLLC

  • Dermatology Physician
  • Cedar City, UT
  • NPI 1902041668

  Dermatology

  NPD
• Kirk Eye LLC

  • Ophthalmologic Surgery Clinic/Center
  • Richfield, UT
  • NPI 1427677095
  NPD (past)
• Pinnacle Dermatology, SC

  • Dermatology Physician
  • Joliet, IL
  • NPI 1861930984

  Dermatology

  NPD (past)

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

{
    "created_epoch": "1386806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1275964504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "861 N MAIN ST",
            "city": "RICHFIELD",
            "state": "UT",
            "postal_code": "847011840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "861 N MAIN ST",
            "city": "RICHFIELD",
            "state": "UT",
            "postal_code": "847011840",
            "telephone_number": "435-558-7031",
            "fax_number": "702-576-9609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "CRAIG",
        "middle_name": "ALLEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-12-12",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NV",
            "license": "PA1471",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "12256467-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennie Rioja
• Allene Roberts, BSN, RN
• Ben Carter Robinson, MD
• Benjamin Ray Robinson, P.T.
• Cole W Robinson, MD
• Steven Michael Rose
• Thomas D Rose, D.C.
• Thomas Charles Russell Sr., SOCIAL WORK
• Ryza Audiology, LLC
• Lisa Sanders, FNP

• All providers in Richfield, UT
• Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 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.

Verify at the official NPI Registry.