Individual provider Active NPI

Raul Rodriguez, MD

  • Emergency Medicine Physician
  • Woodbridge, VA
National Provider Identifier
1417909839
Registry record updated Jun 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0101031389 Issued in VA
Practice address
2300 Opitz Blvd
Woodbridge, VA 22191-3311
Phone
(703) 670-1313
Fax
(800) 536-8431
NPI assigned
May 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 0101031389 VA Primary

Addresses

Primary practice location

2300 Opitz Blvd
Woodbridge, VA 22191-3311

Mailing address

PO Box 75567
Baltimore, MD 21275-5567
Phone (888) 898-3291

Other identifiers 3

IdentifierTypeStateIssuer
5834813MedicaidVA
0001OtherVABCBS
930109438OtherVARAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20041119000385 VA Practitioner - Emergency Medicine 9234039504 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
94.91 of 100Reported as apm
Quality
92.86
Promoting interoperability
94.93
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Michumi PLLC Emergency Medicine CurrentSince Nov 2, 2020 Accepting new patients
Bestpractices, Inc. Emergency Medicine Past Accepting new patients
Bestpractices, Inc. Emergency Medicine Past Accepting new patients
Riverside Physician Services, Inc. Emergency Medicine Past Accepting new patients
Peninsula Radiological Associates Limited PastSince Nov 2, 2020 Accepting new patients

Locations

12997 Warwick Blvd
Newport News, VA 23602
Phone (757) 369-3357

120 Monticello Ave
Williamsburg, VA 23185
Phone (757) 564-3627

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.

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212451200000",
    "number": "1417909839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 75567",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212755567",
            "telephone_number": "888-898-3291",
            "fax_number": "800-536-8431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 OPITZ BLVD",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913311",
            "telephone_number": "703-670-1313",
            "fax_number": "800-536-8431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "RAUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2008-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101031389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5834813",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0001",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "930109438",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

Verify at the official NPI Registry.