Individual provider Active NPI

David Wayne Rhodes, MD

  • Urology Physician
  • Altadena, CA
National Provider Identifier
1457467094
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
C34195 Issued in CA
Practice address
2124 Midlothian Dr
Altadena, CA 91001-3414
Phone
(626) 798-7042
NPI assigned
Aug 23, 2006
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X C34195 CA Primary

Addresses

Primary practice location

2124 Midlothian Dr
Altadena, CA 91001-3414

Mailing address

2124 Midlothian Dr
Altadena, CA 91001-3414
Phone (626) 798-7042

Other practice location 1

630 S Raymond Ave
Suite 220
Pasadena, CA 91105-3278
Phone (626) 795-8454

Other identifiers 2

IdentifierTypeStateIssuer
340009839OtherCAMEDICARE RR
00C341950OtherCABLUE SHIELD

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090727000524 CA Practitioner - Urology 2769581511 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Arcadia Hospital Past Accepting new patients
Pasadena Hospital Association, LTD. Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1457467094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2124 MIDLOTHIAN DR",
            "city": "ALTADENA",
            "state": "CA",
            "postal_code": "910013414",
            "telephone_number": "626-798-7042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2124 MIDLOTHIAN DR",
            "city": "ALTADENA",
            "state": "CA",
            "postal_code": "910013414",
            "telephone_number": "626-798-7042"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "630 S Raymond Ave",
            "address_2": "Suite 220",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "CA",
            "postal_code": "911053278",
            "country_code": "US",
            "telephone_number": "626-795-8454",
            "fax_number": "626-795-5631",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RHODES",
        "first_name": "DAVID",
        "middle_name": "WAYNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "C34195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "340009839",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00C341950",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Altadena, CA

Sources for this page

Verify at the official NPI Registry.