NPIMap

Individual provider Active NPI

Paul L Rodriguez, MD

  • Diagnostic Radiology Physician
  • Wichita, KS
National Provider Identifier
1841209236
Registry record updated Jan 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
10166 Issued in OK
Practice address
4713 N Portwest Cir
Wichita, KS 67204-2356
Phone
(316) 729-5517
Fax
(316) 729-5655
NPI assigned
Aug 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 10166 OK Primary
Diagnostic Radiology Physician 2085R0202X ME90262 FL
General Practice Physician 208D00000X 04-14664 KS

Addresses

Primary practice location

4713 N Portwest Cir
Wichita, KS 67204-2356

Mailing address

4713 N Portwest Cir
Wichita, KS 67204-2356
Phone (316) 729-5517

Other identifiers 5

IdentifierTypeStateIssuer
BCBS OF KSOtherKSBCBS IND OF KS 000105163
248522505OtherOKMEDICARE
7016639OtherOKAETNA
P00272804OtherOKRR MEDICARE #
100206250BMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME90262FLMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Corridor Medical Services Inc Past Accepting new patients
Mobile Radiology Services, Inc. Past Accepting new patients
F&S Radiology, P.C. Diagnostic Radiology Past Accepting new patients
Franklin & Seidelmann Inc Diagnostic Radiology Past Accepting new patients
Jetrad LLC Diagnostic Radiology Past Accepting new patients
Mobile Picc Lines Inc Past Accepting new patients

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453852800000",
    "number": "1841209236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4713 N PORTWEST CIR",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672042356",
            "telephone_number": "316-729-5517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4713 N PORTWEST CIR",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672042356",
            "telephone_number": "316-729-5517",
            "fax_number": "316-729-5655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "PAUL",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2016-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OK",
            "license": "10166",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME90262",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "KS",
            "license": "04-14664",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS IND OF KS 000105163",
            "identifier": "BCBS OF KS",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "248522505",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7016639",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE #",
            "identifier": "P00272804",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100206250B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.