Individual provider Active NPI

Jackeline Judith Rodriguez-Smith, M.D.

  • Pediatric Rheumatology Physician
  • Cincinnati, OH
National Provider Identifier
1841686136
Registry record updated Jul 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Rheumatology PhysicianTaxonomy code 2080P0216X
License
35.133885 Issued in OH
Practice address
3333 Burnet Ave # Mlc4010
Cincinnati, OH 45229
Phone
(513) 636-8004
NPI assigned
Apr 13, 2015
Last updated
Jul 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Rheumatology Physician 2080P0216X 35.133885 OH Primary

Addresses

Primary practice location

3333 Burnet Ave # Mlc4010
Cincinnati, OH 45229

Mailing address

3333 Burnet Ave # Mlc4010
Cincinnati, OH 45229-3026

Other practice location 1

747 52nd St
Room 245
Oakland, CA 94609-1809
Phone (510) 428-3885

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20210920000813 OH Practitioner - Pediatric Medicine 4284031253 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Connecticut School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3333 Burnet Ave
Cincinnati, OH 45229-3026
Phone (513) 636-4200

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Toledo Hospital CurrentSince Mar 31, 2024 Accepting new patients
Children's Hospital Medical Center CurrentSince Aug 12, 2021 Accepting new patients
The Toledo Hospital CurrentSince Mar 31, 2024 Accepting new patients

Locations

3341 Solutions Ctr
Chicago, IL 60677

3333 Burnet Ave
Cincinnati, OH 45229
Phone (513) 636-4200

3333 Burnet Ave
#4010
Cincinnati, OH 45229
Phone (513) 636-4676

3333 Burnet Ave
#5021
Cincinnati, OH 45229
Phone (513) 636-4225

2142 N Cove Blvd
Toledo, OH 43606
Phone (419) 291-1111

Interoperability endpoints

  • Direct secure messaging: jrodriguezsmith224331@direct.promedica.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1428883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625788800000",
    "number": "1841686136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE # MLC4010",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE # MLC4010",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45229",
            "telephone_number": "513-636-8004"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "747 52nd St",
            "address_2": "Room 245",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946091809",
            "country_code": "US",
            "telephone_number": "510-428-3885",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ-SMITH",
        "first_name": "JACKELINE",
        "middle_name": "JUDITH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-13",
        "last_updated": "2021-07-09",
        "certification_date": "2021-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0216X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Rheumatology",
            "state": "OH",
            "license": "35.133885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.