Individual provider Active NPI

Ellana Rodriguez, MD

  • Diagnostic Radiology Physician
  • Paoli, PA
National Provider Identifier
1336374388
Registry record updated Sep 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
436855 Issued in PA
Practice address
255 W Lancaster Ave
Paoli, PA 19301-1763
Phone
(610) 648-1000
Fax
(610) 889-0813
NPI assigned
May 20, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2011

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 436855 PA Primary

Addresses

Primary practice location

255 W Lancaster Ave
Paoli, PA 19301-1763

Mailing address

255 W Lancaster Ave
Paoli, PA 19301-1763
Phone (610) 648-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20090624000584 PA Practitioner - Diagnostic Radiology 1153472535 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology Associates of the Main Line P CGroup PAC ID 9931097193, 80 clinicians

Practice addresses (Care Compare)

100 E Lancaster Ave
Wynewood, PA 19096-3450
Phone (484) 476-2263

101 S Bryn Mawr Ave
Bryn Mawr, PA 19010-3120
Phone (484) 337-4371

1068 W Baltimore Pike
Media, PA 19063-5104
Phone (484) 227-3005

120 Valley Green LN
King of Prussia, PA 19406-2079
Phone (866) 225-5654

130 S Bryn Mawr Ave
Bryn Mawr, PA 19010-3121
Phone (484) 337-4123

154 Exton Square Mall
Exton, PA 19341-2440
Phone (484) 565-8590

1991 Sproul Rd
Broomall, PA 19008-3512
Phone (484) 476-3700

255 W Lancaster Ave
Paoli, PA 19301-1763
Phone (484) 565-1596

3855 W Chester Pike
Newton Square, PA 19073-2304
Phone (484) 337-6149

599 Arcola Rd
Collegeville, PA 19426-3954
Phone (484) 565-8430

80 Lancaster Ave
Devon, PA 19333-1331
Phone (484) 526-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
436855PAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Associates of the Main Line P C Diagnostic Radiology CurrentSince Jul 1, 2009 Accepting new patients
Main Line Health Imaging LP Past Accepting new patients
Main Line Healthcare PastSince Jul 31, 2010 Accepting new patients

Locations

1991 Sproul Rd
Broomall, PA 19008
Phone (484) 476-3700

130 S Bryn Mawr Ave
Bryn Mawr, PA 19010
Phone (484) 337-3000

101 S Bryn Mawr Ave
Bryn Mawr, PA 19010
Phone (610) 526-2200

599 Arcola Rd
Collegeville, PA 19426
Phone (484) 565-8440

1020 Baltimore Pike
Glen Mills, PA 19342
Phone (484) 227-7777

120 Valley Green Ln
Kng of Prussa, PA 19406
Phone (610) 526-3000

1068 W Baltimore Pike
Media, PA 19063
Phone (610) 566-9400

3855 West Chester Pike
Newtown Square, PA 19073
Phone (484) 337-6000

255 W Lancaster Ave
Ste 131
Paoli, PA 19301
Phone (610) 560-8060

255 W Lancaster Ave
Paoli, PA 19301
Phone (484) 337-4286

100 E Lancaster Ave
Wynnewood, PA 19096
Phone (484) 337-3583

306 E Lancaster Ave
Wynnewood, PA 19096
Phone (484) 476-7222

Organizations & group practices 4

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 6

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": "1242777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314921600000",
    "number": "1336374388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 W LANCASTER AVE",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011763",
            "telephone_number": "610-648-1000",
            "fax_number": "610-889-0813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 W LANCASTER AVE",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011763",
            "telephone_number": "610-648-1000",
            "fax_number": "610-889-0813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "ELLANA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-20",
        "last_updated": "2011-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "436855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paoli, PA

Sources for this page

Verify at the official NPI Registry.