Active NPI
Joseph D Roderique, M.D.
- Anesthesiology Physician
- Lakeland, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- ME140352
- Practice address
- 1600 Lakeland Hills Blvd
Lakeland, FL 33805-3065 - Phone
- (863) 680-7000
- Fax
- (866) 264-8519
- NPI assigned
- Jun 2, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Military Health Care Provider | 171000000X | 0101258805 | VA | |
| Anesthesiology Physician | 207L00000X | ME140352 | FL | Primary |
Addresses
Primary practice location
1600 Lakeland Hills Blvd
Lakeland, FL 33805-3065
Mailing address
1600 Lakeland Hills Blvd
Lakeland, FL 33805-3065
Phone (863) 680-7000
Other practice location 1
800 Prudential Dr
Jacksonville, FL 32207-8202
Phone (904) 232-2000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL, OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Virginia Commonwealth University, School of Medicine, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1600 Lakeland Hills Blvd
Lakeland, FL 33805-3019
Phone (863) 680-7000
659 Boulevard St
Dover, OH 44622-2026
Phone (330) 343-3311
Hospital & facility affiliations
- Lakeland Regional Medical Center
- Union Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101258805 | VA | MD | Military Health Care Provider |
| ME140352 | FL | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Partners Physician Group | Current | Accepting new patients | |
| US Anesthesia Partners of Florida Inc. | Anesthesiology | Current | Accepting new patients |
| Watson Clinic LLP | Current | Accepting new patients | |
| Partners Physician Group | Current | Accepting new patients |
Locations
2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000
800 Prudential Dr
Jacksonville, FL 32207
Phone (904) 202-2000
1600 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 680-7190
851 Trafalgar Ct
Ste 200E
Maitland, FL 32751
Phone (321) 422-7155
601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996
1000 Waterman Way
Tavares, FL 32778
Phone (352) 253-3333
224 W Exchange St
Ste 160
Akron, OH 44302
Phone (330) 344-6505
659 Boulevard St
Dover, OH 44622
Phone (330) 343-3311
Organizations & group practices 4
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.
-
- Internal Medicine Physician
- Lakeland, FL
- NPI 1316940695
-
- Surgery Physician
- Akron, OH
- NPI 1841239274
-
- Anesthesiology Physician
- Maitland, FL
- NPI 1518910520
-
- Public Health & General Preventive Medicine Physician
- Akron, OH
- NPI 1164814414
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Lakeland, FL
- NPI 1144228446
-
- Rural Acute Care Hospital
- Dover, OH
- NPI 1871606921
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1401667200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718236800000",
"number": "1760895205",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1600 LAKELAND HILLS BLVD",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338053065",
"telephone_number": "863-680-7000",
"fax_number": "866-264-8519"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 LAKELAND HILLS BLVD",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338053065",
"telephone_number": "863-680-7000",
"fax_number": "866-264-8519"
}
],
"practiceLocations": [
{
"address_1": "800 Prudential Dr",
"address_purpose": "LOCATION",
"city": "Jacksonville",
"state": "FL",
"postal_code": "322078202",
"country_code": "US",
"telephone_number": "904-232-2000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RODERIQUE",
"first_name": "JOSEPH",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-06-02",
"last_updated": "2024-06-13",
"certification_date": "2024-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "171000000X",
"taxonomy_group": "",
"desc": "Military Health Care Provider",
"state": "VA",
"license": "0101258805",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "FL",
"license": "ME140352",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lakeland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2024; 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.