Nicolas R Rodriguez, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

14152 Issued in CA

Practice address

400 E Santa Barbara St Ste C
Santa Paula, CA 93060-2675

Phone

(805) 525-6603

NPI assigned

Jun 29, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern California College of Optometry, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment Care Compare group NPD
• Clinicas del Camino Real Inc

  • Federally Qualified Health Center (FQHC)
  • Ventura, CA
  • NPI 1679631907
  Medicare reassignment NPD
• Clinicas del Camino Real Inc

  • Federally Qualified Health Center (FQHC)
  • Santa Paula, CA
  • NPI 1023234465
  NPD
• Clinicas del Camino Real Inc

  • Community Health Clinic/Center
  • Oxnard, CA
  • NPI 1235866138
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Panorama City, CA
  • NPI 1407888928
  NPD
• Heritage Valley Eye Care Optometric Center

  • Optometrist
  • Santa Paula, CA
  • NPI 1164497905
  NPD (past)
• Heritage Valley Eye Care Optometric Center

  • Optometrist
  • Fillmore, CA
  • NPI 1336202225
  NPD (past)

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

{
    "created_epoch": "1309305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1902193832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17915 TEXAS LN",
            "city": "SANTA PAULA",
            "state": "CA",
            "postal_code": "930609638",
            "telephone_number": "805-933-1849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E SANTA BARBARA ST STE C",
            "city": "SANTA PAULA",
            "state": "CA",
            "postal_code": "930602675",
            "telephone_number": "805-525-6603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "NICOLAS",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-29",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "14152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "5601 De Soto Ave",
            "city": "Woodland Hills",
            "state": "CA",
            "country_code": "US",
            "postal_code": "913676701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• James Rivera
• Nathalie Robles
• Zuleima Rodriguez Sanchez
• Angelica Rodriguez
• Luz Angelica Rodriguez
• Briana Roque, OTD, OTR/L
• Bangalore S Rudraprakasha
• Antonio Ruelas, M.D.
• Diana Rumbo
• Jennelle Marie-Langrill Saavedra

• Optometrist in Santa Paula, CA
• Providers in Santa Paula, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 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.