Individual provider Active NPI

Rodolfo Enrique Fernandez, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Catonsville, MD
National Provider Identifier
1487661237
Registry record updated Apr 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
D0050303 Issued in MD
Practice address
724 Maiden Choice LN
Suite 202
Catonsville, MD 21228-5911
Phone
(410) 747-6080
Fax
(410) 747-3495
NPI assigned
Aug 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X D0050303 MD Primary

Addresses

Primary practice location

724 Maiden Choice LN
Suite 202
Catonsville, MD 21228-5911

Mailing address

724 Maiden Choice LN
Ste 202
Catonsville, MD 21228-5963
Phone (410) 747-6080

Other identifiers 1

IdentifierTypeStateIssuer
090788000MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20080221000358 MD Practitioner - Internal MedicinePractitioner - Other (Physician) 0941297493 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

724 Maiden Choice LN
Suite 202
Catonsville, MD 21228-5963
Phone (410) 747-6080

Hospital & facility affiliations

  • Saint Agnes Hospital Hospital, Baltimore, MD, CCN 210011

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0050303MDMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rodolfo E Fernandez MD PA Geriatric Medicine CurrentSince Sep 1, 2003 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

724 Maiden Choice Ln
Ste 202
Catonsville, MD 21228
Phone (410) 455-0200

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10961/brand/1/csg/1/fhir/r4
  • Direct secure messaging: rodolfo.fernandez.1@10961.direct.athenahealth.com

Organizations & group practices 2

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 1

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": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554768000000",
    "number": "1487661237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "724 MAIDEN CHOICE LN",
            "address_2": "STE 202",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212285963",
            "telephone_number": "410-747-6080",
            "fax_number": "410-747-3495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "724 MAIDEN CHOICE LN",
            "address_2": "SUITE 202",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212285911",
            "telephone_number": "410-747-6080",
            "fax_number": "410-747-3495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "RODOLFO",
        "middle_name": "ENRIQUE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2019-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MD",
            "license": "D0050303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "090788000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Catonsville, MD

Sources for this page

Verify at the official NPI Registry.