Carlos Gustavo Rodriguez, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A56502 Issued in CA

Practice address

1403 N Fair Oaks Ave
Suite 3
Pasadena, CA 91103-1858

Phone

(626) 398-0354

NPI assigned

Jan 10, 2007

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 3

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

Specialty

Family Practice

Education

Other, 1986

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• R & R Clinical & Medical Corp

  • Family Medicine Physician
  • Pasadena, CA
  • NPI 1255471868
  Medicare reassignment NPD Authorized official
• Alhambra Hospital Medical Center, LP

  • General Acute Care Hospital
  • Alhambra, CA
  • NPI 1811099674
  NPD (past)
• MLS Clinical & Medical Corporation

  • Family Medicine Physician
  • Downey, CA
  • NPI 1912146887
  NPD (past)
• Pasadena Primary Care Inc

  • General Practice Physician
  • Pasadena, CA
  • NPI 1679614648
  NPD (past)
• Providence Health System - Southern California

  • General Acute Care Hospital
  • Mission Hills, CA
  • NPI 1477587632
  NPD (past)
• R&R Clinical

  • Clinic/Center
  • Pasadena, CA
  • NPI 1154714772
  NPD (past)

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583193600000",
    "number": "1811046485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1403 N FAIR OAKS AVE",
            "address_2": "SUITE 3",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911031858",
            "telephone_number": "626-398-0354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1403 N FAIR OAKS AVE",
            "address_2": "SUITE 3",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911031858",
            "telephone_number": "626-398-0354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "CARLOS",
        "middle_name": "GUSTAVO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A56502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "00A565020",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A565020",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0100500",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Rodriguez, LMFT
• Ana Isabel Rodriguez
• Annette Rodriguez
• Arlene Isabella Rodriguez
• Breanna Rodriguez
• Carmen Rodriguez
• Carol Patricia Rodriguez, AMFT
• Cecilia Rodriguez
• Christelle Doreese Rodriguez, RAC
• Christine Marie Rodriguez, LCSW

• Family Medicine Physician in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2020; 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.

Verify at the official NPI Registry.