Active NPI
David M Roda, D.O.
- Anesthesiology Physician
- Lancaster, PA
National Provider Identifier
1508887910
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- OS005006L
- Practice address
- 810 Plaza Blvd
Lancaster, PA 17601-2762 - Phone
- (717) 431-2498
- Fax
- (717) 431-2540
- NPI assigned
- Jul 21, 2006
- 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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | OS005006L | PA | Primary |
Addresses
Primary practice location
810 Plaza Blvd
Lancaster, PA 17601-2762
Mailing address
PO Box 667
Lehighton, PA 18235-0667
Phone (570) 386-2366
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000993036001 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS005006L | PA | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1508887910",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 667",
"city": "LEHIGHTON",
"state": "PA",
"postal_code": "182350667",
"telephone_number": "570-386-2366",
"fax_number": "570-386-3130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "810 PLAZA BLVD",
"city": "LANCASTER",
"state": "PA",
"postal_code": "176012762",
"telephone_number": "717-431-2498",
"fax_number": "717-431-2540"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODA",
"first_name": "DAVID",
"middle_name": "M",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "PA",
"license": "OS005006L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000993036001",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lancaster, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.