Individual provider Active NPI

Norberto A Rodriguez, MD

  • Psychiatry Physician
  • San Bernardino, CA
National Provider Identifier
1396706107
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
C167512 Issued in CA
Practice address
820 E Gilbert St
San Bernardino, CA 92415-0928
Phone
(412) 422-4633
Fax
(412) 343-5229
NPI assigned
Mar 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD031330L PA
Psychiatry Physician 2084P0800X C167512 CA Primary

Addresses

Primary practice location

820 E Gilbert St
San Bernardino, CA 92415-0928

Mailing address

6110 E Paseo Cimarron
Tucson, AZ 85750-1113
Phone (412) 760-5444

Other identifiers 2

IdentifierTypeStateIssuer
000556362MedicaidPA
158649OtherPAHIGHMARK BCBS

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
I20220311000646 CA Practitioner - Psychiatry 9739224213 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1964
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
County of San BernardinoGroup PAC ID 3870499130, 76 clinicians

Practice addresses (Care Compare)

820 E Gilbert St
San Bernardino, CA 92415-0928
Phone (909) 387-7200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C167512CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Bernardino CurrentSince Feb 1, 2025 Accepting new patients
County of San Bernardino CurrentSince Feb 1, 2025 Accepting new patients
County of San Bernardino Current Accepting new patients
Associates in Clinical Psychiatry PC Psychiatry PastSince Oct 30, 2001 Accepting new patients

Locations

303 E Vanderbilt Way
Sn Bernrdno, CA 92415
Phone (909) 388-0801

820 E Gilbert St
Sn Bernrdno, CA 92415

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.

NPI Registry JSON

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1396706107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6110 E PASEO CIMARRON",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857501113",
            "telephone_number": "412-760-5444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 E GILBERT ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924150928",
            "telephone_number": "412-422-4633",
            "fax_number": "412-343-5229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "NORBERTO",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD031330L",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "C167512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000556362",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BCBS",
            "identifier": "158649",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.