Individual provider Active NPI

Rodney J Avilla, DO

  • Family Medicine Physician
  • Turlock, CA
National Provider Identifier
1790765428
Registry record updated Jan 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A5487 Issued in CA
Practice address
2101 Geer Rd
#303
Turlock, CA 95382
Phone
(209) 632-3966
Fax
(209) 667-4168
NPI assigned
Jan 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A5487 CA Primary

Addresses

Primary practice location

2101 Geer Rd
#303
Turlock, CA 95382

Mailing address

2101 Geer Rd
#303
Turlock, CA 95382
Phone (209) 632-3966

Other identifiers 1

IdentifierTypeStateIssuer
00AX54870MedicaidCA

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
I20090715000473 CA Practitioner - Family Practice 4688726045 Receives reassigned benefits from 1 practitioner
Practice locations: Turlock, CA

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2101 Geer Rd
Suite 303
Turlock, CA 95382-2470
Phone (209) 632-3966

Hospital & facility affiliations

  • Covenant Care at Home Home health agency, Turlock, CA, CCN 057571
  • Emanuel Medical Center Hospital, Turlock, CA, CCN 050179

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A5487CAMDFamily Medicine Physician

Practice roles (1 of 2)

OrganizationSpecialtyStatusNew patients
Emanuel Medical Center, Inc. PastSince Aug 24, 2020 Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Organizations & group practices 1

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294012800000",
    "number": "1790765428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 GEER RD",
            "address_2": "#303",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "95382",
            "telephone_number": "209-632-3966",
            "fax_number": "209-667-4168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 GEER RD",
            "address_2": "#303",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "95382",
            "telephone_number": "209-632-3966",
            "fax_number": "209-667-4168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVILLA",
        "first_name": "RODNEY",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2011-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A5487",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX54870",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Turlock, CA

Sources for this page

Verify at the official NPI Registry.