Jorge A. Capo-Rodriguez, MD
Individual provider Active NPI Family Medicine Physician · Thermal, CA
NPI 1447564133 · NPPES record last updated Sep 15, 2019
Key facts
- NPI
- 1447564133
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- C150053 (CA)
- Practice address
- 55497 Van Buren St
Thermal, CA 92274-9412 - Phone
- (760) 399-4526
- NPI assigned
- Aug 5, 2010
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Puerto Rico School of Medicine, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Desert Medical Group Inc
Practice addresses (Care Compare)
275 N El Cielo Rd
Palm Springs, CA 92262-6972
Phone (760) 323-8657
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230314002594 | CA | Practitioner - Family Practice | 9739322108 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C150053 | CA | MD | Family Medicine Physician |
| 0101252942 | VA | MD | General Practice Physician |
Practice roles (1 of 2)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Desert Medical Group, Inc. | Family Medicine | Current |
Accepting new patients |
Locations
41120 Washington St
Ste 201
Bermuda Dunes, CA 92203
Phone (760) 360-3193
41120 Washington St
Ste 204
Bermuda Dunes, CA 92203
275 N El Cielo Rd
Palm Springs, CA 92262
Phone (760) 320-8814
55497 Van Buren St
Thermal, CA 92274
Phone (760) 238-5494
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- jcaporodriguez139899@direct.llu.edu
- jorge.caporodriguez.p2@direct.mydohc.nextgenshare.com
- jorge.capo.p5@direct.mydohc.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 0101252942 | VA | |
| General Practice Physician | 208D00000X | 0101252942 | VA | |
| Family Medicine Physician | 207Q00000X | C150053 | CA | Yes |
Addresses
Primary practice location
55497 Van Buren St
Thermal, CA 92274-9412
Mailing address
55497 Van Buren St
Thermal, CA 92274-9412
Phone (760) 600-0601
Other providers in Thermal, CA
- Sergio H Barajas
- Martha Barragan
- Berenice Yudith Becerra Bermudez
- Ana Yanet Becerril
- Jasmin Brown
- Rebeca Carrillo Rodriguez
- Daniela Cervantes-Elia
- Jailine Chavez
- Coachella Valley Unified School District
- Kimberly Contreras
All providers in Thermal, CA · Family Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 15, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.