NPIMap

Individual provider Active NPI

Johnny R Rodriguez, D.O.

  • Surgery Physician
  • Poteau, OK
National Provider Identifier
1457390056
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
3524 Issued in OK
Practice address
105 Wall St
Poteau, OK 74953-4433
Phone
(918) 635-3100
Fax
(918) 635-3398
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 3524 OK Primary

Addresses

Primary practice location

105 Wall St
Poteau, OK 74953-4433

Mailing address

PO Box 1177
Poteau, OK 74953-1177
Phone (918) 635-3100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20080130000677 TX Practitioner - General Surgery 0244290864 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Oklahoma State University College of Osteopathic Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Choctaw Nation of OklahomaGroup PAC ID 1759294838, 271 clinicians

Practice addresses (Care Compare)

1 Choctaw Way
Talihina, OK 74571-2022
Phone (539) 316-6391

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
77.07 of 100Reported as group
Quality
73.06
Improvement activities
40
Cost
69.92

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy37
Hernia repair - groin (open)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3524OKMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Choctaw Nation of Oklahoma CurrentSince Oct 8, 2007 Accepting new patients
Choctaw Nation of Oklahoma CurrentSince Oct 8, 2007 Accepting new patients
Choctaw Nation of Oklahoma Past Accepting new patients
Ahs Henryetta Hospital LLC Past Accepting new patients

Locations

1 Choctaw Way
Talihina, OK 74571
Phone (918) 423-8440

Interoperability endpoints

  • Direct secure messaging: jrodriguez19388@choctawnation.direct-ci.com

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 11

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1457390056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1177",
            "city": "POTEAU",
            "state": "OK",
            "postal_code": "749531177",
            "telephone_number": "918-635-3100",
            "fax_number": "918-635-3398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 WALL ST",
            "city": "POTEAU",
            "state": "OK",
            "postal_code": "749534433",
            "telephone_number": "918-635-3100",
            "fax_number": "918-635-3398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JOHNNY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OK",
            "license": "3524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poteau, OK

Sources for this page

Verify at the official NPI Registry.