Jacquelyn Nicole Rodriguez, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

4301083536 Issued in MI

Practice address

11012 E 13 Mile Rd, Ste # 212
Warren, MI 48093-2572

Phone

(586) 582-7150

Fax

(586) 582-7164

NPI assigned

May 14, 2007

Last updated

Jan 16, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Jacquelyn Nicole Walker Former name

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Obstetrics/Gynecology

Education

Michigan State University College of Human Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Henry Ford Semi Medical GroupGroup PAC ID 0648180406, 246 clinicians

Henry Ford Health Macomb Oakland HospitalGroup PAC ID 7315859725, 155 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Henry Ford Health Warren Hospital Hospital, Warren, MI, CCN 230195
• Henry Ford Health St John Hospital Hospital, Detroit, MI, CCN 230165
• Beaumont Hospital, Troy Hospital, Troy, MI, CCN 230269

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Henry Ford Health Macomb-Oakland Hospital

  dba Henry Ford Warren Hospital

  • Family Medicine Physician
  • Warren, MI
  • NPI 1134176472

  Obstetrics & Gynecology

  Medicare reassignment Care Compare group NPD
• Henry Ford Semi Medical Group

  • Family Medicine Physician
  • Warren, MI
  • NPI 1942317631

  Obstetrics & Gynecology

  Medicare reassignment Care Compare group NPD
• Henry Ford Health St. John Hospital

  dba St John North Shores Hospital

  • Podiatrist
  • Harrison Township, MI
  • NPI 1043478910
  Medicare reassignment NPD
• Henry Ford Health Macomb-Oakland Hospital

  dba Henry Ford Warren Hospital

  • Social Worker
  • Warren, MI
  • NPI 1548609761
  NPD
• Henry Ford Health St. John Hospital

  dba Henry Ford St John Hospital

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1912965088

  Obstetrics & Gynecology

  NPD
• Henry Ford Semi Medical Group

  • Endocrinology, Diabetes & Metabolism Physician
  • Novi, MI
  • NPI 1114133485

  Obstetrics & Gynecology

  NPD
• Henry Ford Semi Medical Group

  • Family Medicine Physician
  • Harper Woods, MI
  • NPI 1902979081

  Obstetrics & Gynecology

  NPD
• Pathology Specialists of Southeast Michigan PC

  • Anatomic Pathology & Clinical Pathology Physician
  • Detroit, MI
  • NPI 1023100500
  NPD
• Henry Ford Health St. John Hospital

  dba St John Hospital and Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1023088168
  NPD
• Ascension Macomb Oakland Hospital

  dba Michigan Neuro-Ophthalmology & Oculoplastic Surgery

  • Ophthalmology Physician
  • Madison Heights, MI
  • NPI 1114962461
  NPD (past)

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

• Henry Ford Health Macomb Oakland Hospital

  dba St. John Macomb Oakland Hospital-Warren Campus

  • General Acute Care Hospital
  • Warren, MI
  • NPI 1124099858
  Care Compare affiliation
• Henry Ford Health Macomb Oakland Hospital

  dba St John Macomb Oakland - Oakland Center

  • General Acute Care Hospital
  • Madison Heights, MI
  • NPI 1215139233
  Care Compare affiliation
• William Beaumont Hospital

  dba Beaumont Hospital, Troy

  • General Acute Care Hospital
  • Troy, MI
  • NPI 1306825997
  Care Compare affiliation
• Henry Ford Health St. John Hospital

  dba St John Hospital and Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1023088168
  Care Compare affiliation

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232064000000",
    "number": "1427264902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11012 E 13 MILE RD, STE # 212",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480932572",
            "telephone_number": "586-582-7150",
            "fax_number": "586-582-7164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11012 E 13 MILE RD, STE # 212",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480932572",
            "telephone_number": "586-582-7150",
            "fax_number": "586-582-7164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JACQUELYN",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-14",
        "last_updated": "2009-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "4301083536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM PIN NUMBER",
            "identifier": "16-0502308-2",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELYN",
            "last_name": "WALKER",
            "middle_name": "NICOLE",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Matthew Rodemeyer, DPT
• Jordin Shelley Roden-Foreman, DO
• Tawanna Rodgers
• Amanda Kay Rodino
• Isable Marie Rodriguez
• Jeanna Marie Rodriguez
• Bonnie Ruth Rodziewicz
• Danielle Rodzik
• Phyllis Ruth Roelofs
• Geertruida C Roer, GNP

• Obstetrics & Gynecology Physician in Warren, MI
• Providers in Warren, MI by specialty
• Obstetrics & Gynecology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.