Geraldine Mercedes Dodge, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA19831 Issued in CA

Practice address

150 Valpreda Rd
San Marcos, CA 92069-2973

Phone

(760) 736-8747

NPI assigned

Jul 29, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Rock Springs Physician Group LLC

  • Psychiatry Physician
  • Georgetown, TX
  • NPI 1205221397
  Medicare reassignment

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

{
    "created_epoch": "1217289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423785600000",
    "number": "1639335771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 VALPREDA RD",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920692973",
            "telephone_number": "760-736-8747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 VALPREDA RD",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920692973",
            "telephone_number": "760-736-8747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DODGE",
        "first_name": "GERALDINE",
        "middle_name": "MERCEDES",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-29",
        "last_updated": "2015-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA19831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Larissa Dingman
• Annalysa Dixon
• Cathy DO, RPH
• Jackie Van DO, FNP
• Pierre Doche, DMD
• Amy Dollbaum, PHARM.D.
• Nicolette E. Dome-Yutsus, AU.D.
• Danielle Dominguez-Rodriguez
• Nichola Donadio-Lewis, SLP
• Alexandra Ripich Donnelly, LCSW

• Physician Assistant in San Marcos, CA
• Providers in San Marcos, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2015; 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.