Individual provider Active NPI

Olga Rodziyevska, PA-C

  • Medical Physician Assistant
  • Houston, TX
National Provider Identifier
1740560820
Registry record updated Apr 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA11844 Issued in TX
Practice address
6410 Fannin St Ste 500
Houston, TX 77030-3005
Phone
(281) 935-5917
Fax
(713) 500-0530
NPI assigned
Aug 22, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC01189 TX
Medical Physician Assistant 363AM0700X PA11844 TX Primary

Addresses

Primary practice location

6410 Fannin St Ste 500
Houston, TX 77030-3005

Mailing address

6410 Fannin St Ste 732
Houston, TX 77030-5202
Phone (281) 935-5917

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20180430000388 TX Practitioner - Physician Assistant 7012271067 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AC01189TXMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians CurrentSince Apr 2, 2018 Accepting new patients
Ut Physicians CurrentSince Apr 2, 2018 Accepting new patients

Locations

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

6410 Fannin St
Ste 732
Houston, TX 77030
Phone (713) 500-5482

Organizations & group practices 2

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": "1313971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522713600000",
    "number": "1740560820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6410 FANNIN ST STE 732",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770305202",
            "telephone_number": "281-935-5917",
            "fax_number": "713-500-0530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6410 FANNIN ST STE 500",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770303005",
            "telephone_number": "281-935-5917",
            "fax_number": "713-500-0530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODZIYEVSKA",
        "first_name": "OLGA",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-22",
        "last_updated": "2018-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "TX",
            "license": "AC01189",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA11844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.