Ubaldo R Rodriguez, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

29894 Issued in MO

Practice address

1600 Heritage LNDG
Ste 215
Saint Peters, MO 63303-8489

Phone

(636) 939-4200

Fax

(636) 939-4204

NPI assigned

Mar 31, 2006

Last updated

Jul 22, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Practice Management Affiliates Consulting Inc

  • Family Medicine Physician
  • Saint Peters, MO
  • NPI 1053341289
  NPD (past)

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374451200000",
    "number": "1649231275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 HERITAGE LNDG",
            "address_2": "STE 215",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633038489",
            "telephone_number": "636-939-4200",
            "fax_number": "636-939-4204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 HERITAGE LNDG",
            "address_2": "STE 215",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633038489",
            "telephone_number": "636-939-4200",
            "fax_number": "636-939-4204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "UBALDO",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2013-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MO",
            "license": "29894",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "505243003",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danielle Marie Robinson, PA-C
• Mary Roche, PT, CHT
• Talia M Roche, PHARMD
• Deidra Deann Rodriguez
• Kenneth Rodriguez, LMT
• Renee Rogers
• Taylor Renee Rogers, MA, LCPC, LPC
• Rachel Rojano, RD
• John Edward Romeo, FNP-BC
• Delaina C Root, OT

• General Practice Physician in Saint Peters, MO
• Providers in Saint Peters, MO by specialty
• General Practice Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.