Jose Ildefonso Rodriguez Moreno, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

MD202077 Issued in OR

Practice address

2900 State St Ste 101
Medford, OR 97504-8458

Phone

(541) 789-5790

NPI assigned

Jul 14, 2016

Last updated

Jul 14, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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

Neurology

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

LGH Medical Group, Inc.Group PAC ID 3173626751, 165 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Asante Rogue Regional Medical Center Hospital, Medford, OR, CCN 380018
• Merrimack Health Lawrence Hospital Hospital, Lawrence, MA, CCN 220010
• Asante Three Rivers Medical Center Hospital, Grants Pass, OR, CCN 380002
• Holy Family Hospital Hospital, Methuen, MA, CCN 220080
• Lowell General Hospital Hospital, Lowell, MA, CCN 220063

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jrodriguezmoreno147168@tuftsmedicine.direct-ci.com

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.

• LGH Medical Group, Inc.

  • Hospitalist Physician
  • Lowell, MA
  • NPI 1174698385
  Medicare reassignment Care Compare group NPD
• LGH Professional Services LLC

  • Internal Medicine Physician
  • Lowell, MA
  • NPI 1417485541
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Asante

  dba Asante Rogue Regional Medical Center

  • General Acute Care Hospital
  • Medford, OR
  • NPI 1770587107
  Care Compare affiliation
• Asante Three Rivers Medical Center, LLC

  • General Acute Care Hospital
  • Grants Pass, OR
  • NPI 1801891809
  Care Compare affiliation
• Lawrence General Hospital

  dba Merrimack Health Lawrence Hospital

  • General Acute Care Hospital
  • Lawrence, MA
  • NPI 1750381281
  Care Compare affiliation
• LG Newcorp Inc

  dba Merrimack Health Methuen Hospital

  • General Acute Care Hospital
  • Methuen, MA
  • NPI 1265267991
  Care Compare affiliation
• The Lowell General Hospital

  dba Lowell General Hospital

  • General Acute Care Hospital
  • Lowell, MA
  • NPI 1407804669
  Care Compare affiliation

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

{
    "created_epoch": "1468454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626220800000",
    "number": "1891148854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 STATE ST STE 101",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048458",
            "telephone_number": "541-789-5790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 STATE ST STE 101",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048458",
            "telephone_number": "541-789-5790"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41 Mall Rd",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "MA",
            "postal_code": "018053700",
            "country_code": "US",
            "telephone_number": "781-353-8167",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 Washington St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021111552",
            "country_code": "US",
            "telephone_number": "617-636-5848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ MORENO",
        "first_name": "JOSE",
        "middle_name": "ILDEFONSO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-14",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "MA",
            "license": "267707",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OR",
            "license": "MD202077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul A Rock, CADC II
• Martin Rodden, OTR/L
• Linda Ann Rodgers, WHNP WOMENS HEALTH N
• Melanie Jenee Rodgers, CERTIFICATE
• Graciela Rodriguez Miranda
• Christa Monique Rodriguez, LMT
• Darnal Rodriguez
• Martha Griselda Rodriguez
• Seth Andrew Rodriguez, LCSW
• Shasta Rodriguez

• Neurology Physician in Medford, OR
• Providers in Medford, OR by specialty
• Neurology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2021; 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.