Active NPI
Timothy Paul Roderiques
- Private Vehicle
- New Bedford, MA
National Provider Identifier
1912479007
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Private Vehicle
- License
- S79139087
- Practice address
- 48 Ocean St
New Bedford, MA 02740-3555 - Phone
- (508) 509-0631
- NPI assigned
- Dec 30, 2018
- Last updated
- Dec 30, 2018
- 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 |
|---|---|---|---|---|
| Private Vehicle | 347C00000X | S79139087 | MA | Primary |
Addresses
Primary practice location
48 Ocean St
New Bedford, MA 02740-3555
Mailing address
48 Ocean St
New Bedford, MA 02740-3555
Phone (508) 509-0631
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 |
|---|---|---|---|
| S79139087 | MA | MD | Private Vehicle |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1546128000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1546128000000",
"number": "1912479007",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "48 OCEAN ST",
"city": "NEW BEDFORD",
"state": "MA",
"postal_code": "027403555",
"telephone_number": "508-509-0631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "48 OCEAN ST",
"city": "NEW BEDFORD",
"state": "MA",
"postal_code": "027403555",
"telephone_number": "508-509-0631"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODERIQUES",
"first_name": "TIMOTHY",
"middle_name": "PAUL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-12-30",
"last_updated": "2018-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "347C00000X",
"taxonomy_group": "",
"desc": "Private Vehicle",
"state": "MA",
"license": "S79139087",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Bedford, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.