Individual provider Active NPI

Maria Rodionova, DO

  • Family Medicine Physician
  • Tripler Army Medical Center, HI
National Provider Identifier
1306229976
Registry record updated May 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1653 Issued in NE
Practice address
1 Jarrett White Rd
Tripler Army Medical Center
Tripler Army Medical Center, HI 96859-5001
Phone
(808) 433-4049
NPI assigned
Jul 1, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 1653 NE Primary

Addresses

Primary practice location

1 Jarrett White Rd
Tripler Army Medical Center
Tripler Army Medical Center, HI 96859-5001

Mailing address

1 Jarrett White Road
Tripler Army Medical Center
Tamc, HI 96819-5001

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170809003782 NE Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 9133490139

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
1653NEMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1435708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1306229976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 JARRETT WHITE ROAD",
            "address_2": "TRIPLER ARMY MEDICAL CENTER",
            "city": "TAMC",
            "state": "HI",
            "postal_code": "968195001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 JARRETT WHITE RD",
            "address_2": "TRIPLER ARMY MEDICAL CENTER",
            "city": "TRIPLER ARMY MEDICAL CENTER",
            "state": "HI",
            "postal_code": "968595001",
            "telephone_number": "808-433-4049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODIONOVA",
        "first_name": "MARIA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-01",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "1653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tripler Army Medical Center, HI

Sources for this page

Verify at the official NPI Registry.