Lauren Nicole-Kubeck Rodgers, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA51922 Issued in CA

Practice address

7365 Carnelian St Ste 137
Rancho Cucamonga, CA 91730-1100

Phone

(909) 948-8888

NPI assigned

Sep 26, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jack W Griffith III, DO

  • Dermatology Physician
  • Rancho Cucamonga, CA
  • NPI 1407884315
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1411689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640736000000",
    "number": "1538562103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7365 CARNELIAN ST STE 137",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917301100",
            "telephone_number": "909-948-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7365 CARNELIAN ST STE 137",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917301100",
            "telephone_number": "909-948-8888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1601 Monte Vista Ave",
            "address_2": "Suite 190",
            "address_purpose": "LOCATION",
            "city": "Claremont",
            "state": "CA",
            "postal_code": "917112962",
            "country_code": "US",
            "telephone_number": "909-865-9977",
            "fax_number": "909-946-0166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODGERS",
        "first_name": "LAUREN",
        "middle_name": "NICOLE-KUBECK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-26",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA51922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kim Rodrigues
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• Nydia Rodriguez Quitiquit
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• Physician Assistant in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.