NPIMap

Individual provider Active NPI

Mark Jervis Rodrigues, M.D.

  • Internal Medicine Physician
  • Orange, CA
National Provider Identifier
1417977992
Registry record updated Jan 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
107415 Issued in CA
Practice address
1140 W la Veta Ave
Suite #470
Orange, CA 92868-4223
Phone
(714) 245-9900
Fax
(714) 245-9901
NPI assigned
Jul 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 107415 CA Primary
Pulmonary Disease Physician 207RP1001X 107415 CA

Addresses

Primary practice location

1140 W la Veta Ave
Suite #470
Orange, CA 92868-4223

Mailing address

1140 W la Veta Ave
Suite #470
Orange, CA 92868-4223
Phone (714) 245-9900

Other identifiers 2

IdentifierTypeStateIssuer
00A463400MedicaidCA
330801446OtherCAEMPLOYER ID

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090325000648 CA Practitioner - Internal MedicinePractitioner - Pulmonary DiseasePractitioner - Sleep Medicine 1557428281 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pulmonary Disease, Sleep Medicine
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1140 W la Veta Ave
Suite 470
Orange, CA 92868-4200
Phone (714) 245-9900

1140 W la Veta Ave
Suite 470
Orange, CA 92868-4223

Hospital & facility affiliations

  • Elite Care Home Health Services, Inc Home health agency, Los Angeles, CA, CCN 559409
  • Hoag Home Health Home health agency, Newport Beach, CA, CCN 557412
  • Ambassadore Healthcare, Inc Home health agency, Long Beach, CA, CCN 559599
  • Acacia HH&P of Southern California, LLC Home health agency, Irvine, CA, CCN 559093
  • Providence St. Joseph Hospital Hospital, Orange, CA, CCN 050069
  • Hoag Memorial Hospital Presbyterian Hospital, Newport Beach, CA, CCN 050224
  • Memorialcare Long Beach Medical Center Hospital, Long Beach, CA, CCN 050485

Merit-based Incentive Payment System (MIPS)

Final score
94.17 of 100Reported as individual
Quality
88.33
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
107415CAMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Breathe Diagnostics, Inc. CurrentSince Jun 1, 2016 Accepting new patients
Mark J Rodrigues MD Inc Internal Medicine CurrentSince Jan 21, 1993 Accepting new patients
Orange County Global Medical Center, Inc Past Accepting new patients
St Joseph Hospital of Orange Past Accepting new patients

Locations

1140 W La Veta Ave
Ste 470
Orange, CA 92868
Phone (714) 245-9900

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DEFAAA
  • FHIR API: https://fhir4.healow.com/fhir/r4/DEFAAA/Endpoint/DEFAAA

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 8

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294358400000",
    "number": "1417977992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 W LA VETA AVE",
            "address_2": "SUITE #470",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684223",
            "telephone_number": "714-245-9900",
            "fax_number": "714-245-9901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 W LA VETA AVE",
            "address_2": "SUITE #470",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684223",
            "telephone_number": "714-245-9900",
            "fax_number": "714-245-9901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUES",
        "first_name": "MARK",
        "middle_name": "JERVIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2011-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "107415",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "107415",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A463400",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPLOYER ID",
            "identifier": "330801446",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.