Alyssa Rodaniche, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA16170 Issued in TX

Practice address

11521 N FM 620 Rd Ste 945
Austin, TX 78726-1115

Phone

(512) 318-2559

Fax

(512) 782-9316

NPI assigned

Aug 10, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Texas Tech University Health Science Center School of Medicine, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Privia Medical Group Gulf Coast PLLCGroup PAC ID 4688999022, 511 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: alyssa.rodaniche.1@8042.direct.athenahealth.com

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.

• Privia Medical Group Gulf Coast, PLLC

  • Obstetrics & Gynecology Physician
  • Houston, TX
  • NPI 1578969465
  Medicare reassignment Care Compare group NPD
• Total MD Physicians Group, PLLC

  • Family Medicine Physician
  • Austin, TX
  • NPI 1982031852
  Medicare reassignment
• Privia Medical Group Gulf Coast PLLC

  • Interventional Pain Medicine Physician
  • San Antonio, TX
  • NPI 1457167033
  NPD

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

{
    "created_epoch": "1597017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1821609355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8300 N LAMAR BLVD STE 200A",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787535976",
            "telephone_number": "512-575-9555",
            "fax_number": "512-782-9316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11521 N FM 620 RD STE 945",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787261115",
            "telephone_number": "512-318-2559",
            "fax_number": "512-782-9316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODANICHE",
        "first_name": "ALYSSA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-10",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA16170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica L. Rockwood, M.D.
• Sheldon Elisabeth Rockwood, MD
• Rocky Mountain Laboratories
• Rocky Mountain Laboratories LLC
• Rocky Mountain Laser, L.P.
• Raquel Alison Roddy, CNP
• Ariana Rodela
• Ashley Suzanne Rodgers, M.S., CCC-SLP
• Elizabeth Weaver Rodgers, RBT, BA
• George P Rodgers, MD

• Physician Assistant in Austin, TX
• Providers in Austin, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.

Verify at the official NPI Registry.