Macy Roderick, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA01394 Issued in RI

Practice address

100 Kenyon Ave
Wakefield, RI 02879-4216

Phone

(401) 782-8000

NPI assigned

Sep 3, 2021

Last updated

Aug 19, 2025By the provider in NPPES

Sex

Female

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 RI, HI2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Emergency Physician Associates of New England PC

  • Emergency Medicine Physician
  • Wakefield, RI
  • NPI 1427381052
  Medicare reassignment
• The Emergency Group, Inc.

  • Emergency Medicine Physician
  • Honolulu, HI
  • NPI 1013943414
  Medicare reassignment
• Diagnostic Laboratory Services, Inc

  • Clinical Medical Laboratory
  • Aiea, HI
  • NPI 1215930987
  NPD (past)

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

{
    "created_epoch": "1630627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755561600000",
    "number": "1922776897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 KAPIOLANI BLVD",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968135212",
            "telephone_number": "808-597-8791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 KENYON AVE",
            "city": "WAKEFIELD",
            "state": "RI",
            "postal_code": "028794216",
            "telephone_number": "401-782-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "770 Kapiolani Blvd",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "968135212",
            "country_code": "US",
            "telephone_number": "808-597-8791",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODERICK",
        "first_name": "MACY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-03",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "HI",
            "license": "AMD-1238",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "RI",
            "license": "PA01394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Curhan,MD. Inc
• Robert K. Chinn, MD
• Robert S Gilardetti, DMD, MD, Inc (South County Oral, Maxillofacial and Implant Surgical Center)
• Stephanie A Roberts, LPTA
• Melissa Ann Roch, APRN, FNP-C
• John W Rodger, PA
• Debra Mary Rodgers
• Allison M Romano, BSW, BA
• Michael J Roncarati, PT
• Peter Raymond Rossi Jr., M.S., LMFT

• Physician Assistant in Wakefield, RI
• Providers in Wakefield, RI by specialty
• Physician Assistant in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.