Mark William Rodehaver, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

36905 Issued in MA

Practice address

1330 Beacon St
Suite 263
Brookline, MA 02446-3282

Phone

(617) 566-2859

NPI assigned

Jul 19, 2006

Sex

Male

Sole proprietor

Yes

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

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760401053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 WINTHROP RD",
            "address_2": "4",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024454678",
            "telephone_number": "617-566-2859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 BEACON ST",
            "address_2": "SUITE 263",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024463282",
            "telephone_number": "617-566-2859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODEHAVER",
        "first_name": "MARK",
        "middle_name": "WILLIAM",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MA",
            "license": "36905",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2033917",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kiana Robinson
• Marta Robinson
• Neha Mulchand Robinson, M.D.
• Kristin Ardella Robison, L.AC.
• Alan S Rockoff, M.D.
• Carolyn Combs Rodgers
• Melissa Rodier, MS OTR/L
• Michelle Roditti
• Rodrigo F Rangel DDS, PLLC
• Evelyn Martha Rodriguez, M.S. CCC-SLP

• Specialist in Brookline, MA
• Providers in Brookline, MA by specialty
• Specialist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.