Individual provider Active NPI

Rodrigo Gerardo

  • Surgery Physician
  • Dayton, OH
National Provider Identifier
1629575048
Registry record updated Oct 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
35.140753 Issued in OH
Practice address
128 E. Apple St.
Wche 7TH Floor
Dayton, OH 45409
Phone
(937) 208-4953
NPI assigned
Apr 11, 2018
Last updated
Oct 23, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Surgery Physician 208600000X 35.140753 OH Primary

Addresses

Primary practice location

128 E. Apple St.
Wche 7TH Floor
Dayton, OH 45409

Mailing address

128 E. Apple St.
Wche 7TH Floor
Dayton, OH 45409

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20201221001331 OH Practitioner - General Surgery 9830447846 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Wright State University Boonshoft School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

13207 Ravenna Rd
Chardon, OH 44024-7032
Phone (216) 383-0100

13207 Ravenna Rd H
Chardon, OH 44024-7032
Phone (216) 383-0100

158 W Main Rd
Conneaut, OH 44030-2039

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Primary Care Practices Inc Current Accepting new patients
University Primary Care Practices Inc CurrentSince Sep 1, 2025 Accepting new patients
University Primary Care Practices Inc CurrentSince Sep 1, 2025 Accepting new patients
CG Medical Associates Inc CurrentSince Jul 9, 2024 Accepting new patients
University Primary Care Practices Past Accepting new patients
University Hospitals Medical Group Inc Surgery Past Accepting new patients

Locations

158 W Main Rd
Ste 203
Conneaut, OH 44030
Phone (440) 285-2960

2131 Gateway Dr
Fairborn, OH 45324
Phone (937) 873-9500

846 State Route 28
Milford, OH 45150
Phone (513) 831-8555

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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": "1523404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603411200000",
    "number": "1629575048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 E. APPLE ST.",
            "address_2": "WCHE 7TH FLOOR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "45409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 E. APPLE ST.",
            "address_2": "WCHE 7TH FLOOR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "45409",
            "telephone_number": "937-208-4953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERARDO",
        "first_name": "RODRIGO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-11",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "35.140753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.