Individual provider Active NPI

Cynthia D Rodriguez, FNP

  • Nurse Practitioner
  • Corvallis, OR
National Provider Identifier
1427009497
Registry record updated Jun 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2005501697NP FNP-PP Issued in OR
Practice address
3680 NW Samaritan Dr
Corvallis, OR 97330-3737
Phone
(541) 754-1150
NPI assigned
May 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2005501697NP FNP-PP OR Primary

Addresses

Primary practice location

3680 NW Samaritan Dr
Corvallis, OR 97330-3737

Mailing address

444 NW Elks Dr
Corvallis, OR 97330-3745

Other identifiers 1

IdentifierTypeStateIssuer
005745MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060206000922 OR Practitioner - Nurse Practitioner 6709891195 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Corvallis Clinic P CGroup PAC ID 1456244540, 128 clinicians

Practice addresses (Care Compare)

3680 NW Samaritan Dr
Corvallis, OR 97330-3737
Phone (541) 754-1150

Merit-based Incentive Payment System (MIPS)

Final score
88.16 of 100Reported as group
Quality
84.81
Promoting interoperability
100
Improvement activities
40
Cost
75.71

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2005501697NP FNP-PPORMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Corvallis Clinic P C CurrentSince Apr 1, 2006 Accepting new patients

Locations

444 NW Elks Dr
Corvallis, OR 97330
Phone (541) 754-1256

3680 NW Samaritan Dr
Corvallis, OR 97330
Phone (541) 754-1282

Interoperability endpoints

  • Direct secure messaging: cynthia.rodriguez.1@14349.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/14349/brand/4/csg/42/fhir/r4

Organizations & group practices 1

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": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244160000000",
    "number": "1427009497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 NW ELKS DR",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3680 NW SAMARITAN DR",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303737",
            "telephone_number": "541-754-1150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "CYNTHIA",
        "middle_name": "D",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-15",
        "last_updated": "2009-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "2005501697NP FNP-PP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005745",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

Verify at the official NPI Registry.