Active NPI
Kenny Morales Rodriguez, MD
- Pediatrics Physician
- Los Angeles, CA
National Provider Identifier
1528645330
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 196897
- Practice address
- 757 Westwood PLZ
Los Angeles, CA 90095-8358 - Phone
- (310) 825-9111
- NPI assigned
- Mar 26, 2021
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 196897 | CA | Primary |
Addresses
Primary practice location
757 Westwood PLZ
Los Angeles, CA 90095-8358
Mailing address
235 S San Pedro St Apt 604
Los Angeles, CA 90012-3583
Phone (323) 541-3996
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240809000223 | CA | Order and Referring Only - Pediatric Medicine | 3577000447 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 196897 | CA | MD | Pediatrics Physician |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725235200000",
"number": "1528645330",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "235 S SAN PEDRO ST APT 604",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900123583",
"telephone_number": "323-541-3996"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "757 WESTWOOD PLZ",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900958358",
"telephone_number": "310-825-9111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORALES RODRIGUEZ",
"first_name": "KENNY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-26",
"last_updated": "2024-09-02",
"certification_date": "2024-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "196897",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2024; 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.