Active NPI
Robert L Rodrigues, M.D.
- Plastic and Reconstructive Surgery Physician
- West Valley City, UT
National Provider Identifier
1316910748
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic and Reconstructive Surgery Physician
- License
- 6172029-1205
- Practice address
- 3725 W 4100 S
West Valley City, UT 84120-5530 - Phone
- (801) 965-3600
- Fax
- (801) 965-3526
- NPI assigned
- Feb 8, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Hand Surgery Physician | 207XS0106X | 48028 | MN | |
| Plastic and Reconstructive Surgery Physician | 2086S0122X | 6172029-1205 | UT | Primary |
Addresses
Primary practice location
3725 W 4100 S
West Valley City, UT 84120-5530
Mailing address
3725 W 4100 S
West Valley City, UT 84120-5530
Phone (801) 965-3600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 620176800 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 48028 | MN | MD | Orthopaedic Hand Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1368403200000",
"number": "1316910748",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3725 W 4100 S",
"city": "WEST VALLEY CITY",
"state": "UT",
"postal_code": "841205530",
"telephone_number": "801-965-3600",
"fax_number": "801-965-3526"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3725 W 4100 S",
"city": "WEST VALLEY CITY",
"state": "UT",
"postal_code": "841205530",
"telephone_number": "801-965-3600",
"fax_number": "801-965-3526"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUES",
"first_name": "ROBERT",
"middle_name": "L",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-08",
"last_updated": "2013-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "207XS0106X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Hand Surgery",
"state": "MN",
"license": "48028",
"primary": false
},
{
"code": "2086S0122X",
"taxonomy_group": "",
"desc": "Surgery, Plastic and Reconstructive Surgery",
"state": "UT",
"license": "6172029-1205",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "620176800",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in West Valley City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.