Active NPI
Justin Rodante, PAC
- Medical Physician Assistant
- Bethesda, MD
National Provider Identifier
1932254356
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- C05297
- Practice address
- 10 Center Drive Building 10 CRC MSC 1476
Room 5-3140
Bethesda, MD 20892-0001 - Phone
- (301) 827-6417
- NPI assigned
- Jan 24, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA30321 | DC | |
| Medical Physician Assistant | 363AM0700X | C05297 | MD | Primary |
Addresses
Primary practice location
10 Center Drive Building 10 CRC MSC 1476
Room 5-3140
Bethesda, MD 20892-0001
Mailing address
10 Center Drive MSC 1476
Room 5-3140
Bethesda, MD 20892-0001
Phone (301) 827-6417
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 024905300 | Medicaid | DC |
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA30321 | DC | MD | Physician Assistant |
| C05297 | MD | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464652800000",
"number": "1932254356",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 CENTER DRIVE MSC 1476",
"address_2": "ROOM 5-3140",
"city": "BETHESDA",
"state": "MD",
"postal_code": "208920001",
"telephone_number": "301-827-6417"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 CENTER DRIVE BUILDING 10 CRC MSC 1476",
"address_2": "ROOM 5-3140",
"city": "BETHESDA",
"state": "MD",
"postal_code": "208920001",
"telephone_number": "301-827-6417"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODANTE",
"first_name": "JUSTIN",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-24",
"last_updated": "2016-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "DC",
"license": "PA30321",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "MD",
"license": "C05297",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "024905300",
"state": "DC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bethesda, MD
- Rockledge Surgery Center, Inc.
- Rockville Eye Surgery Center, LLC
- Rockville Eye Surgery Center, LLC
- Robyn Michelle Rockwell, MHS, RDN, CSO
- Colleen Mary Rodak, N.P.
- Griffin Platt Rodgers, MD
- Annelie Christina Roding, PA
- Anita Rodrigues, RN
- Maria del Carmen Rodriguez Pena
- Benixa Marie Rodriguez-Gonzalez
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.