Active NPI
Luis Felipe Rodriguez, MD
- Geriatric Medicine (Internal Medicine) Physician
- Portland, OR
National Provider Identifier
1497757447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Internal Medicine) Physician
- License
- MD26869
- Practice address
- 13007 NE Glisan St
Portland, OR 97230-2545 - Phone
- (503) 215-7866
- Fax
- (503) 215-7864
- NPI assigned
- Aug 10, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | MD26869 | OR | Primary |
Addresses
Primary practice location
13007 NE Glisan St
Portland, OR 97230-2545
Mailing address
13007 NE Glisan St
Portland, OR 97230-2545
Phone (503) 215-7866
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11604802 | Medicaid | TX |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | lrodriguez189270@oc.providencedirect.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150429000932 | OR | Order and Referring Only - Geriatric Medicine | 3072576255 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601424000000",
"number": "1497757447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13007 NE GLISAN ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972302545",
"telephone_number": "503-215-7866",
"fax_number": "503-215-7864"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13007 NE GLISAN ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972302545",
"telephone_number": "503-215-7866",
"fax_number": "503-215-7864"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "LUIS",
"middle_name": "FELIPE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-08-10",
"last_updated": "2020-09-30",
"certification_date": "2020-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Geriatric Medicine",
"state": "OR",
"license": "MD26869",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "11604802",
"state": "TX"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "lrodriguez189270@oc.providencedirect.org",
"affiliation": "N",
"address_1": "13007 NE Glisan St",
"city": "Portland",
"state": "OR",
"country_code": "US",
"postal_code": "972302545",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 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.