Individual provider Active NPI

Deborah Ann Rodriguez, MD

  • Pediatrics Physician
  • Federal Way, WA
National Provider Identifier
1306932405
Registry record updated Sep 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD00038294 Issued in WA
Practice address
34503 9TH Ave South
#220
Federal Way, WA 98003
Phone
(253) 927-3243
Fax
(253) 627-0855
NPI assigned
Oct 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD00038294 WA Primary

Addresses

Primary practice location

34503 9TH Ave South
#220
Federal Way, WA 98003

Mailing address

316 Martin Luther King Jr Way
#212
Tacoma, WA 98405
Phone (253) 383-5777

Other identifiers 1

IdentifierTypeStateIssuer
8265290MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201103002460 WA Practitioner - Pediatric Medicine 4385054337 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Aug 1, 2020 Accepting new patients
Multicare Health System Pediatrics CurrentSince Aug 1, 2020 Accepting new patients
Multicare Health System Current Accepting new patients
Chuck R. Colas, D.O., P.C. Past Accepting new patients
N W Pediatric Center Inc P S Pediatrics Past Accepting new patients

Locations

1911 Cooks Hill Rd
Centralia, WA 98531
Phone (360) 736-6552

505 S 336th St
Ste 210
Federal Way, WA 98003
Phone (253) 383-5777

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

316 S K St
Ste 212
Tacoma, WA 98405
Phone (253) 383-5777

Interoperability endpoints

  • Direct secure messaging: drodriguezmd4585@direct.multicare.org

Organizations & group practices 5

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348185600000",
    "number": "1306932405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 MARTIN LUTHER KING JR WAY",
            "address_2": "#212",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "98405",
            "telephone_number": "253-383-5777",
            "fax_number": "253-627-0855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34503 9TH AVE SOUTH",
            "address_2": "#220",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "98003",
            "telephone_number": "253-927-3243",
            "fax_number": "253-627-0855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "DEBORAH",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2012-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD00038294",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8265290",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Federal Way, WA

Sources for this page

Verify at the official NPI Registry.