Individual provider Active NPI

Fabian Ortiz-Rodriguez

  • Clinical Social Worker
  • San Jose, CA
National Provider Identifier
1285118208
Registry record updated Apr 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1555 Parkmoor Ave
San Jose, CA 95128-2407
Phone
(408) 288-0450
Fax
(408) 282-0400
NPI assigned
Sep 17, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

1555 Parkmoor Ave
San Jose, CA 95128-2407

Mailing address

PO Box 127
Napa, CA 94559-0127
Phone (707) 255-3300

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220425002109 CA Practitioner - Clinical Social Worker 6103213954 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hope ServicesGroup PAC ID 5597716233, 29 clinicians

Practice addresses (Care Compare)

1555 Parkmoor Ave
San Jose, CA 95128-2407
Phone (408) 282-0402

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hope Services CurrentSince Apr 1, 2022 Accepting new patients
Hope Services CurrentSince Apr 1, 2022 Accepting new patients
Southern California Permanente Medical Group Past Accepting new patients

Locations

1555 Parkmoor Ave
San Jose, CA 95128
Phone (408) 282-0402

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": "1537142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648771200000",
    "number": "1285118208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 127",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945590127",
            "telephone_number": "707-255-3300",
            "fax_number": "408-282-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 PARKMOOR AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282407",
            "telephone_number": "408-288-0450",
            "fax_number": "408-282-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ-RODRIGUEZ",
        "first_name": "FABIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-17",
        "last_updated": "2022-04-01",
        "certification_date": "2022-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.