Individual provider Active NPI

Emily Rodda, PNP

  • Pediatric Nurse Practitioner
  • San Mateo, CA
National Provider Identifier
1619300423
Registry record updated Jul 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
23362 Issued in CA
Practice address
222 W. 39TH Avenue
San Mateo Medical Center - Pediatric Clinic
San Mateo, CA 94403
Phone
(650) 573-3702
NPI assigned
Aug 15, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 23362 CA Primary

Addresses

Primary practice location

222 W. 39TH Avenue
San Mateo Medical Center - Pediatric Clinic
San Mateo, CA 94403

Mailing address

222 W. 39TH Avenue
San Mateo Medical Center - Pediatric Clinic
San Mateo, CA 94403
Phone (650) 573-3702

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161007000796 CA Practitioner - Nurse Practitioner 7315235371 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23362CAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Mateo CurrentSince Aug 15, 2016 Accepting new patients
County of San Mateo CurrentSince Aug 10, 2019 Accepting new patients
County of San Mateo Current Accepting new patients
County of San Mateo CurrentSince Aug 15, 2016 Accepting new patients

Locations

380 90th St
Daly City, CA 94015
Phone (650) 301-8600

2710 Middlefield Rd
Redwood City, CA 94063
Phone (650) 364-6010

222 W 39th Ave
San Mateo, CA 94403
Phone (415) 573-2222

Interoperability endpoints

  • Direct secure messaging: erodda19171@smch.direct-ci.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1376524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467763200000",
    "number": "1619300423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 W. 39TH AVENUE",
            "address_2": "SAN MATEO MEDICAL CENTER - PEDIATRIC CLINIC",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "94403",
            "telephone_number": "650-573-3702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 W. 39TH AVENUE",
            "address_2": "SAN MATEO MEDICAL CENTER - PEDIATRIC CLINIC",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "94403",
            "telephone_number": "650-573-3702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODDA",
        "first_name": "EMILY",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-15",
        "last_updated": "2016-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "23362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

Verify at the official NPI Registry.