Mary J Monroe-Rodman, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G63395 Issued in CA

Practice address

2081 Bronze Star Dr
Woodland, CA 95776-5423

Phone

(530) 668-2600

Fax

(530) 661-1027

NPI assigned

Jul 25, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Dr. Mary J Monroe Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594857600000",
    "number": "1477576148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "address_2": "ATTN CREDENTIALING/PAYER ENROLLMENT",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2081 BRONZE STAR DR",
            "city": "WOODLAND",
            "state": "CA",
            "postal_code": "957765423",
            "telephone_number": "530-668-2600",
            "fax_number": "530-661-1027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONROE-RODMAN",
        "first_name": "MARY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2020-07-16",
        "certification_date": "2020-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G63395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00681680",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00G633950",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "MONROE",
            "middle_name": "J",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Patricia L Moore-Pickett, MD
• Alyssa Shay Moore
• Pamela June Moore, RAD INTERN

• Family Medicine Physician in Woodland, CA
• Providers in Woodland, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.