Individual provider Active NPI

Adrianna Sofia Rodriguez, M.D.

  • Dermatology Physician
  • Suwanee, GA
National Provider Identifier
1457586612
Registry record updated Aug 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
069432 Issued in GA
Practice address
4285 Johns Creek Pkwy
Suite a
Suwanee, GA 30024-6038
Phone
(770) 622-4412
NPI assigned
May 18, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 069432 GA Primary

Addresses

Primary practice location

4285 Johns Creek Pkwy
Suite a
Suwanee, GA 30024-6038

Mailing address

4285 Johns Creek Pkwy
Suite a
Suwanee, GA 30024-6038
Phone (770) 622-4412

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20130723000585 GA Practitioner - Dermatology 7618118332 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
New York University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Associates of Georgia, LLCGroup PAC ID 3678547569, 11 clinicians

Practice addresses (Care Compare)

1951 Clairmont Rd
Decatur, GA 30033-3415
Phone (404) 321-4600

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions371
Skin biopsy158

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
069432GAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Associates of Georgia, LLC CurrentSince Aug 1, 2013 Accepting new patients

Locations

1951 Clairmont Rd
Decatur, GA 30033
Phone (404) 321-4600

4285 Johns Creek Pkwy
#A
Suwanee, GA 30024
Phone (770) 622-4412

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: adrianna.rodriguez.p1@direct.dermga.nextgenshare.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1242604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375833600000",
    "number": "1457586612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4285 JOHNS CREEK PKWY",
            "address_2": "SUITE A",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246038",
            "telephone_number": "770-622-4412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4285 JOHNS CREEK PKWY",
            "address_2": "SUITE A",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246038",
            "telephone_number": "770-622-4412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "ADRIANNA",
        "middle_name": "SOFIA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-18",
        "last_updated": "2013-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "069432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

Verify at the official NPI Registry.