Individual provider Active NPI

David M Roda, D.O.

  • Anesthesiology Physician
  • Lancaster, PA
National Provider Identifier
1508887910
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
OS005006L Issued in PA
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

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
000993036001MedicaidPA

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

LicenseStateTypeSpecialty
OS005006LPAMDAnesthesiology 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.

Verify at the official NPI Registry.