NPIMap

Individual provider Active NPI

George Nader Rodenko, M.D.

  • Diagnostic Radiology Physician
  • Odessa, TX
National Provider Identifier
1336141084
Registry record updated Jan 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
H9563 Issued in TX
Practice address
500 W 4TH St
Odessa, TX 79761-5001
Phone
(432) 640-1273
Fax
(432) 640-4606
NPI assigned
Aug 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X H9563 TX Primary

Addresses

Primary practice location

500 W 4TH St
Odessa, TX 79761-5001

Mailing address

PO Box 2129
Odessa, TX 79760-2129
Phone (432) 640-2408

Other identifiers 1

IdentifierTypeStateIssuer
102008308MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041112000603 TX Practitioner - Diagnostic Radiology 0547224222 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Texas Medical Branch at Galveston, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCH Professional Care Hospital BasedGroup PAC ID 1557535127, 81 clinicians

Practice addresses (Care Compare)

500 W 4TH St
Odessa, TX 79761-5001
Phone (432) 640-2401

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.41 of 100Reported as group
Quality
72.52
Improvement activities
40
Cost
81.49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
H9563TXMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MCH Professional Care Hospital Based Diagnostic Radiology CurrentSince Oct 1, 2011 Accepting new patients
Southwest Medical Imaging PA Diagnostic Radiology Past Accepting new patients
MCH Professional Care Radiology Diagnostic Radiology Past Accepting new patients
Ector County Hospital District Past Accepting new patients
Permian Basin Radiology, LLC Diagnostic Radiology PastSince Sep 1, 2003 Accepting new patients

Locations

500 W 4th St
Odessa, TX 79761
Phone (432) 640-1000

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357776000000",
    "number": "1336141084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2129",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797602129",
            "telephone_number": "432-640-2408",
            "fax_number": "432-640-4606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W 4TH ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797615001",
            "telephone_number": "432-640-1273",
            "fax_number": "432-640-4606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODENKO",
        "first_name": "GEORGE",
        "middle_name": "NADER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2013-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "H9563",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102008308",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

Verify at the official NPI Registry.