Carson Rodeffer, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

A168432 Issued in CA

Practice address

1552 Coffee Rd FL 1
Modesto, CA 95355-3122

Phone

(209) 521-4372

Fax

(095) 232-0052

NPI assigned

Jun 14, 2016

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

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Obstetrics/Gynecology

Education

University of Florida College of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hera OB-GYN Medical Group IncGroup PAC ID 6305905837, 6 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: crodeffer552571@hisp.ehr.sutterhealth.org
• Direct secure messaging: carson.rodeffer.1@33563.direct.athenahealth.com

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.

• Hera OBGYN Medical Group, Inc.

  • Obstetrics & Gynecology Physician
  • Modesto, CA
  • NPI 1992710768
  Medicare reassignment Care Compare group NPD
• First Choice Physician Partners

  • Neurological Surgery Physician
  • Modesto, CA
  • NPI 1104183052
  Medicare reassignment
• Doctors Medical Center of Modesto, Inc.

  • General Acute Care Hospital
  • Modesto, CA
  • NPI 1184654923
  NPD (past)

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

{
    "created_epoch": "1465862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595289600000",
    "number": "1679923387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1552 COFFEE RD FL 1",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953553122",
            "telephone_number": "095-214-3722",
            "fax_number": "095-232-0052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1552 COFFEE RD FL 1",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953553122",
            "telephone_number": "209-521-4372",
            "fax_number": "095-232-0052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODEFFER",
        "first_name": "CARSON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-14",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A168432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Rocha
• Natalie Azucena Rocha
• Yessenia Rocha
• Paola Rodarte Torres
• Jocelyn Rodarte, DPT, PT
• Denise Rodenburg
• Hannah Joy Rodens
• Keri Berbena Rodgers, RN
• Melissa Marie Rodgers, M.D.
• Monica Rodgers

• Obstetrics & Gynecology Physician in Modesto, CA
• Providers in Modesto, CA by specialty
• Obstetrics & Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.