Jacob Rodriguez

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

14190579-1206 Issued in UT

Practice address

325 W Logan Rd
Garden City, UT 84028-7754

Phone

(208) 232-7862

NPI assigned

Aug 9, 2022

Last updated

Nov 20, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT, ID2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Health West IncGroup PAC ID 4981500931, 67 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Brigham City Community Hospital Hospital, Brigham City, UT, CCN 460017

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jacob.rodriguez.1@16258.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Health West, Inc.

  dba Health West Providence

  • Federally Qualified Health Center (FQHC)
  • Providence, UT
  • NPI 1528774452
  Medicare reassignment Care Compare group
• Health West, Inc.

  dba Health West Preston Clinic

  • Federally Qualified Health Center (FQHC)
  • Preston, ID
  • NPI 1033595541
  Medicare reassignment NPD
• Health West, Inc.

  dba Health West North Logan

  • Federally Qualified Health Center (FQHC)
  • North Logan, UT
  • NPI 1457067381

  Family Medicine

  NPD
• Health West, Inc.

  dba Pocatello High School

  • Federally Qualified Health Center (FQHC)
  • Pocatello, ID
  • NPI 1124794060
  NPD
• Health West, Inc.

  dba Health West Aberdeen Clinic

  • Federally Qualified Health Center (FQHC)
  • Aberdeen, ID
  • NPI 1295734796

  Family Medicine

  NPD
• Health West, Inc.

  dba Health West American Falls Clinic

  • Federally Qualified Health Center (FQHC)
  • American Falls, ID
  • NPI 1629077235

  Family Medicine

  NPD
• Health West, Inc.

  dba Sryinga Elementary School

  • Federally Qualified Health Center (FQHC)
  • Pocatello, ID
  • NPI 1740143882
  NPD
• Health West, Inc.

  dba Health West City Center

  • Federally Qualified Health Center (FQHC)
  • Pocatello, ID
  • NPI 1013547801
  NPD (past)
• Health West, Inc.

  dba Health West Chubbuck Clinic

  • Federally Qualified Health Center (FQHC)
  • Chubbuck, ID
  • NPI 1629499751
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Brigham City Community Hospital, Inc.

  dba Brigham City Community Hospital

  • General Acute Care Hospital
  • Brigham City, UT
  • NPI 1245282227
  Care Compare affiliation

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

{
    "created_epoch": "1660003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1316675382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S 11TH AVE STE 400",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014880",
            "telephone_number": "208-232-7862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 W LOGAN RD",
            "city": "GARDEN CITY",
            "state": "UT",
            "postal_code": "840287754",
            "telephone_number": "208-232-7862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JACOB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-09",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "14190579-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Health West, Inc. (Health West Garden City)
• Health West, Inc. (Health West Garden City Pharmacy)
• Health West, Inc. (Health West Garden City Dental)
• Kam E Jarman, MPT
• Taya Rae Peterson
• Selanie Ann Sanone, DNP
• Tracy Ann Seel, PA
• Mark C. Weston, DDS

• Physician Assistant in Garden City, UT
• Providers in Garden City, UT by specialty
• Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; 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.