Active NPI
Roderick R Stuart, M.D.
- Psychiatry Physician
- San Bernardino, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- A107492
- Practice address
- 325 W Hospitality LN
Suite 312
San Bernardino, CA 92408-3243 - Phone
- (866) 205-3595
- NPI assigned
- Feb 6, 2008
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | A107492 | CA | Primary |
Addresses
Primary practice location
325 W Hospitality LN
Suite 312
San Bernardino, CA 92408-3243
Mailing address
325 W Hospitality LN
Suite 312
San Bernardino, CA 92408-3243
Phone (866) 205-3595
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA, HI
- 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
- Psychiatry
- Education
- Loma Linda University School of Medicine, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
10800 Magnolia Ave
Riverside, CA 92505-3043
Phone (951) 353-2000
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A107492 | CA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Hawaii Permanente Medical Group Inc | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients |
Locations
9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910
393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914
10800 Magnolia Ave
Riverside, CA 92505
Phone (951) 353-2000
711 Kapiolani Blvd
Honolulu, HI 96813
Phone (808) 432-5312
3288 Moanalua Rd
Honolulu, HI 96819
Phone (808) 265-9205
55 Maui Lani Pkwy
Wailuku, HI 96793
Phone (808) 243-6000
Organizations & group practices 3
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.
-
- Health Maintenance Organization
- Riverside, CA
- NPI 1316979834
-
- Health Maintenance Organization
- Honolulu, HI
- NPI 1710945969
-
- Health Maintenance Organization
- Santa Clarita, CA
- NPI 1316409410
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202256000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638403200000",
"number": "1801074463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "325 W HOSPITALITY LN",
"address_2": "SUITE 312",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924083243",
"telephone_number": "866-205-3595"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "325 W HOSPITALITY LN",
"address_2": "SUITE 312",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924083243",
"telephone_number": "866-205-3595"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STUART",
"first_name": "RODERICK",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-02-06",
"last_updated": "2021-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A107492",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Southern California Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "10800 Magnolia Ave",
"city": "Riverside",
"state": "CA",
"country_code": "US",
"postal_code": "925053043",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in San Bernardino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2021; 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.