Active NPI
Ruben R Rodis Jr.
- Assisted Living Facility
- Surprise, AZ
National Provider Identifier
1871229161
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- License
- AL7402H
- Practice address
- 15550 W Cameron Dr
Surprise, AZ 85379-1055 - Phone
- (623) 234-8655
- Fax
- (623) 234-1335
- NPI assigned
- Jul 28, 2022
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | AL7402H | AZ | Primary |
Addresses
Primary practice location
15550 W Cameron Dr
Surprise, AZ 85379-1055
Mailing address
15550 W Cameron Dr
Surprise, AZ 85379-1055
Phone (623) 234-8655
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AL7402H | AZ | MD | Assisted Living Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1658966400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658966400000",
"number": "1871229161",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15550 W CAMERON DR",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853791055",
"telephone_number": "623-234-8655",
"fax_number": "623-234-1335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15550 W CAMERON DR",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853791055",
"telephone_number": "623-234-8655",
"fax_number": "623-234-1335"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODIS",
"first_name": "RUBEN",
"middle_name": "R",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-07-28",
"last_updated": "2022-07-28",
"certification_date": "2022-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "AZ",
"license": "AL7402H",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Surprise, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.