Roberto Luis Rodriguez, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

M3717 Issued in TX

Practice address

10775 Pioneer TRL Ste 215
Truckee, CA 96161-0234

Phone

(415) 424-4266

Fax

(415) 520-6633

NPI assigned

Aug 22, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 13

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Central Texas Community Health Centers

  dba CommUnityCare

  • Family Medicine Physician
  • Austin, TX
  • NPI 1427882091
  Medicare reassignment NPD
• Peoples Community Clinic Inc

  • Clinic/Center
  • Austin, TX
  • NPI 1598896391
  Medicare reassignment NPD
• Central Texas Community Health Centers

  dba CommUnityCare

  • Federally Qualified Health Center (FQHC)
  • Austin, TX
  • NPI 1598591414
  NPD
• People's Community Clinic, Inc.

  dba People's Community Clinic Off-Site Clinic at Manor

  • Federally Qualified Health Center (FQHC)
  • Manor, TX
  • NPI 1083019905
  NPD
• Northeast Valley Health Corporation

  dba SCV Dental and Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Santa Clarita, CA
  • NPI 1548960834
  NPD (past)
• Northeast Valley Health Corporation

  dba Van Nuys Adult Health Center

  • Federally Qualified Health Center (FQHC)
  • Van Nuys, CA
  • NPI 1629079009
  NPD (past)
• Telehealth Services USA

  dba Hazel Health Services

  • Pediatrics Physician
  • Truckee, CA
  • NPI 1275035263
  NPD (past)
• Central Texas Community Health Centers

  dba CommUnityCare--Southeast Health & Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Austin, TX
  • NPI 1861420382
  NPD (past)
• City of Austin

  dba City of Austin Office of Chief Medical Officer

  • Emergency Medical Services (Emergency Medicine) Physician
  • Austin, TX
  • NPI 1083245070
  NPD (past)
• University of Texas Medical Branch, Austin Initiatives at Utmb

  • Internal Medicine Physician
  • Austin, TX
  • NPI 1144393802

  Family Medicine

  NPD (past)
• Utmb Austin - Initiatives

  • Multi-Specialty Clinic/Center
  • Austin, TX
  • NPI 1427099506
  NPD (past)

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667520000000",
    "number": "1548252836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10775 PIONEER TRL STE 215",
            "city": "TRUCKEE",
            "state": "CA",
            "postal_code": "961610234",
            "telephone_number": "415-424-4266",
            "fax_number": "415-520-6633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10775 PIONEER TRL STE 215",
            "city": "TRUCKEE",
            "state": "CA",
            "postal_code": "961610234",
            "telephone_number": "415-424-4266",
            "fax_number": "415-520-6633"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4865 Market St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191393508",
            "country_code": "US",
            "telephone_number": "267-425-9800",
            "fax_number": "267-425-9999",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3928 Cal Rodgers St",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787235457",
            "country_code": "US",
            "telephone_number": "512-300-5062",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "ROBERTO",
        "middle_name": "LUIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-22",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME155078",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "93641",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "65186",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A88020",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "HI",
            "license": "MD-22303",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2022002034",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD61238004",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NV",
            "license": "21793",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD421935",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "DR.0067576",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "M3717",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D95328",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036158875",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002472",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "181402206",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "830105662",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "250016795",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100241921",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2200757",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000199578",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106158",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Rix, LCSW
• Robert J. Colpitts, D,D,S, Inc.
• Michelle Joy Robinson, LCSW, LICSW
• Angela Rodriguez, CPNP
• Jesus Rodriguez
• Jenna Rohlf
• Rose Behavior Consulting LLC
• Allan Sengco Rosete
• Adrienne Rossi
• Chelsea Lynn Roth, LCSW

• Pediatrics Physician in Truckee, CA
• Providers in Truckee, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2022; 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.

Verify at the official NPI Registry.