Active NPI
Frederick G. Rodosta, M.D.
- Urology Physician
- Opelousas, LA
National Provider Identifier
1609859156
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 010172
- Practice address
- 305 E Prudhomme St
Opelousas, LA 70570-6490 - Phone
- (337) 948-6511
- Fax
- (337) 948-6512
- NPI assigned
- Nov 29, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Urology Physician | 208800000X | 010172 | LA | Primary |
Addresses
Primary practice location
305 E Prudhomme St
Opelousas, LA 70570-6490
Mailing address
305 E Prudhomme St
Opelousas, LA 70570-6490
Phone (337) 948-6511
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0632240001 | Other | LA | DURABLE MEDICAL EQUIPMENT |
| 1112071 | Medicaid | LA | |
| 342009015 | Other | LA | RAILROAD MEDICARE |
| 720700403 | Other | LA | TAX ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
- 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 |
|---|---|---|---|---|
| I20070314000041 | LA | Practitioner - Urology | 9436252301 | Practice locations: Opelousas, LA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 010172 | LA | MD | Urology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1609859156",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "305 E PRUDHOMME ST",
"city": "OPELOUSAS",
"state": "LA",
"postal_code": "705706490",
"telephone_number": "337-948-6511",
"fax_number": "337-948-6512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "305 E PRUDHOMME ST",
"city": "OPELOUSAS",
"state": "LA",
"postal_code": "705706490",
"telephone_number": "337-948-6511",
"fax_number": "337-948-6512"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODOSTA",
"first_name": "FREDERICK",
"middle_name": "G.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-11-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "LA",
"license": "010172",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DURABLE MEDICAL EQUIPMENT",
"identifier": "0632240001",
"state": "LA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1112071",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "342009015",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "720700403",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Opelousas, LA
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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.