Individual provider Active NPI

Wolfgang Fabio Rodriguez, M.D.

  • Family Medicine Physician
  • Omaha, NE
National Provider Identifier
1568519692
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
30193 Issued in NE
Practice address
4220 L St
Omaha, NE 68107-1048
Phone
(402) 733-4433
Fax
(402) 733-1220
NPI assigned
Jan 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 7216 NE
Family Medicine Physician 207Q00000X 30193 NE Primary

Addresses

Primary practice location

4220 L St
Omaha, NE 68107-1048

Mailing address

7261 Mercy Rd
Omaha, NE 68124-2311
Phone (402) 733-4433

Other identifiers 1

IdentifierTypeStateIssuer
7216OtherNENEBRASKA BOARD OF MEDICINE AND SURGERY-TEP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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

Enrollment IDStateProvider typePAC IDDetails
I20170726000402 NE Practitioner - Family Practice 5991869315 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alegent Creighton ClinicGroup PAC ID 1951210418, 951 clinicians

Practice addresses (Care Compare)

16909 Lakeside Hills CT
Omaha, NE 68130-4661

3308 Samson Way
Bellevue, NE 68123-3234
Phone (402) 291-3373

4220 L St
Suite 100
Omaha, NE 68107-1048
Phone (402) 733-4433

Hospital & facility affiliations

  • CHI Health at Home - Omaha Home health agency, Omaha, NE, CCN 287019
  • CHI Health Bergan Mercy Hospital, Omaha, NE, CCN 280060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
16542CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Creighton Clinic Family Medicine CurrentSince Sep 1, 2017 Accepting new patients
Alegent Creighton Clinic Family Medicine Past Accepting new patients

Locations

2771 Solution Ctr
Chicago, IL 60677

3308 Samson Way
Bellevue, NE 68123
Phone (402) 291-3373

7261 Mercy Rd
Omaha, NE 68124
Phone (402) 398-6248

4220 L St
Ste 100
Omaha, NE 68107
Phone (402) 733-4433

16909 Lakeside Hills Ct
Ste 401
Omaha, NE 68130
Phone (402) 827-4920

4220 L St
Omaha, NE 68107
Phone (402) 717-7050

Organizations & group practices 2

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

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1568519692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7261 MERCY RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681242311",
            "telephone_number": "402-733-4433",
            "fax_number": "402-733-1220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4220 L ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681071048",
            "telephone_number": "402-733-4433",
            "fax_number": "402-733-1220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "WOLFGANG",
        "middle_name": "FABIO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "7216",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "30193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEBRASKA BOARD OF MEDICINE AND SURGERY-TEP",
            "identifier": "7216",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.