Individual provider Active NPI

Caithness Amy Rodriguez, MD

  • Family Medicine Physician
  • Irvine, CA
National Provider Identifier
1346576469
Registry record updated Feb 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A109744 Issued in CA
Practice address
14150 Culver Dr
Suite 100
Irvine, CA 92604-0315
Phone
(949) 857-0290
Fax
(949) 551-5612
NPI assigned
Oct 23, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A109744 CA Primary

Addresses

Primary practice location

14150 Culver Dr
Suite 100
Irvine, CA 92604-0315

Mailing address

14150 Culver Dr
Suite 100
Irvine, CA 92604-0315
Phone (949) 857-0290

Other names 1

  • Dr. Caithness A Vibbard Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20100517000517 CA Practitioner - Family Practice 6709914435 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
109744CAMDClinical Social Worker
A109744CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorialcare Medical Foundation Family Medicine CurrentSince Dec 10, 2017 Accepting new patients
Bristol Park Medical Group, Inc Family Medicine Past Accepting new patients

Locations

722 Baker St
Costa Mesa, CA 92626
Phone (714) 557-6300

17360 Brookhurst St
Fountain Vly, CA 92708
Phone (657) 241-3592

14150 Culver Dr
Ste 100
Irvine, CA 92604
Phone (949) 552-4584

1300 Avenida Vista Hermosa
Ste 250
San Clemente, CA 92673
Phone (949) 240-2030

Organizations & group practices 2

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": "1256256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486598400000",
    "number": "1346576469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14150 CULVER DR",
            "address_2": "SUITE 100",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926040315",
            "telephone_number": "949-857-0290",
            "fax_number": "949-551-5612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14150 CULVER DR",
            "address_2": "SUITE 100",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926040315",
            "telephone_number": "949-857-0290",
            "fax_number": "949-551-5612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "CAITHNESS",
        "middle_name": "AMY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-23",
        "last_updated": "2017-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A109744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAITHNESS",
            "last_name": "VIBBARD",
            "middle_name": "A",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.