Nicole Dominique Roderos, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA66480 Issued in CA

Practice address

1180 N Indian Canyon Dr Ste W201
Palm Springs, CA 92262-4876

Phone

(760) 416-4575

NPI assigned

Apr 23, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

First Choice Physician PartnersGroup PAC ID 0941465322, 130 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Desert Regional Medical Center Hospital, Palm Springs, CA, CCN 050243

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nicole.roderos.1@14035.direct.athenahealth.com

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.

• First Choice Physician Partners

  • Neurological Surgery Physician
  • Modesto, CA
  • NPI 1104183052
  Medicare reassignment Care Compare group
• First Choice Physician Partners

  • Family Medicine Physician
  • Palm Springs, CA
  • NPI 1558797118
  NPD
• First Choice Physician Partners

  • Ophthalmology Physician
  • El Monte, CA
  • NPI 1912732892
  NPD
• First Choice Physician Partners

  • Internal Medicine Physician
  • Modesto, CA
  • NPI 1912264862
  NPD (past)

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

• Desert Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Palm Springs, CA
  • NPI 1104856095
  Care Compare affiliation

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

{
    "created_epoch": "1745366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755475200000",
    "number": "1437946381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 N INDIAN CANYON DR STE W201",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922624876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 N INDIAN CANYON DR STE W201",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922624876",
            "telephone_number": "760-416-4575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODEROS",
        "first_name": "NICOLE DOMINIQUE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-23",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA66480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Austin Roberts, MD
• Shelby Christine Roberts, MD
• Jamie Robinson, FNP-C
• Esther Robles, LVN
• Alexis Rodarte
• Amy Zabinski Rodnick, P.A.-C
• Kassandra Rodriguez Castro, LVN
• Aryanna Rodriguez
• Britany Rodriguez
• Daisy Rodriguez

• Physician Assistant in Palm Springs, CA
• Providers in Palm Springs, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2025; 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.