Individual provider Active NPI

Cassie Leean Rodriguez, PA

  • Physician Assistant
  • Grass Valley, CA
National Provider Identifier
1750152393
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
65702 Issued in CA
Practice address
844 Old Tunnel Rd
Grass Valley, CA 95945-8524
Phone
(530) 274-9762
NPI assigned
Jan 11, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 65702 CA Primary

Addresses

Primary practice location

844 Old Tunnel Rd
Grass Valley, CA 95945-8524

Mailing address

844 Old Tunnel Rd
Grass Valley, CA 95945-8524
Phone (530) 274-9762

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250307001191 CA Order and Referring Only - Family PracticePractitioner - Family Practice 3577084458

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
65702CAMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: cassie.rodriguez@wsmc1.eclinicaldirectplus.com

NPI Registry JSON

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

{
    "created_epoch": "1704931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1750152393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "844 OLD TUNNEL RD",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959458524",
            "telephone_number": "530-274-9762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "844 OLD TUNNEL RD",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959458524",
            "telephone_number": "530-274-9762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "CASSIE",
        "middle_name": "LEEAN",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-11",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "65702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grass Valley, CA

Sources for this page

Verify at the official NPI Registry.