NPIMap

Individual provider Active NPI

Alberto Rodriguez, P.A.

  • Physician Assistant
  • Vancouver, WA
National Provider Identifier
1396993556
Registry record updated Jun 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA01439 Issued in OR
Practice address
16821 SE McGillivray Blvd
Vancouver, WA 98683-0499
Phone
(360) 433-9580
Fax
(866) 824-5107
NPI assigned
Aug 29, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X LL18188 OR
Physician Assistant 363A00000X PA01439 OR Primary

Addresses

Primary practice location

16821 SE McGillivray Blvd
Vancouver, WA 98683-0499

Mailing address

728 Molalla Ave a B
Oregon City, OR 97045-2799
Phone (503) 656-9030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120305000615 OR Practitioner - Physician Assistant 7911166368 Reassigns benefits to 1 organization
I20130109000110 WA Practitioner - Physician Assistant 7911166368 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2005 Cedar St
Forest Grove, OR 97116-1701

Hospital & facility affiliations

  • Providence Seaside Hospital Hospital, Seaside, OR, CCN 381303
  • Hillsboro Medical Center Hospital, Hillsboro, OR, CCN 380021
  • Adventist Health Tillamook Hospital, Tillamook, OR, CCN 381317

Merit-based Incentive Payment System (MIPS)

Final score
83.81 of 100Reported as group
Quality
71.23
Promoting interoperability
88
Improvement activities
40
Cost
81.9

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
LL18188ORMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Center for Pain Management CurrentSince Jun 1, 2022 Accepting new patients
Care Partners Past Accepting new patients
Sports and Spine Past Accepting new patients
Oregon City Medical Past Accepting new patients

Locations

1900 116th Ave NE
Ste 100
Bellevue, WA 98004
Phone (425) 753-3174

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ACBEAD
  • FHIR API: https://fhir4.healow.com/fhir/r4/HDJBCD/Endpoint/HDJBCD
  • Direct secure messaging: alberto.rodriguez@nwpi.eclinicaldirectplus.com

Organizations & group practices 6

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 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1219968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1396993556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "728 MOLALLA AVE A B",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970452799",
            "telephone_number": "503-656-9030",
            "fax_number": "503-656-9026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16821 SE MCGILLIVRAY BLVD",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986830499",
            "telephone_number": "360-433-9580",
            "fax_number": "866-824-5107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "ALBERTO",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-29",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "LL18188",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA01439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.