Active NPI
Shaunda Marie Rodriguez, D.O.
- Plastic Surgery within the Head & Neck (Otolaryngology) Physician
- Wichita, KS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery within the Head & Neck (Otolaryngology) Physician
- License
- 05-38208
- Practice address
- 1947 N Founders Cir
Wichita, KS 67206-3548 - Phone
- (316) 613-4680
- Fax
- (316) 613-4906
- NPI assigned
- Aug 20, 2008
- Last updated
- Jul 1, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 931 | NE | |
| Plastic Surgery within the Head & Neck (Otolaryngology) Physician | 207YX0007X | OTO12165 | PA | |
| Plastic Surgery within the Head & Neck (Otolaryngology) Physician | 207YX0007X | 05-38208 | KS | Primary |
Addresses
Primary practice location
1947 N Founders Cir
Wichita, KS 67206-3548
Mailing address
PO Box 8035
Wichita, KS 67208-0035
Phone (316) 689-9135
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Otolaryngology
- Education
- At Still University of Health Sciences, College of Osteo Med, Kirksville, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1947 N Founders Cir
Via Christi Clinic PA
Wichita, KS 67206-3548
Phone (316) 613-4640
Hospital & facility affiliations
- Ascension Via Christi Hospitals Wichita, Inc.
- Via Christi Hospital Wichita St Teresa, Inc
- Ascension Via Christi Rehabilitation Hospital, Inc
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05-38208 | KS | MD | Plastic Surgery within the Head & Neck (Otolaryngology) Physician |
| OTO12165 | PA | MD | Plastic Surgery within the Head & Neck (Otolaryngology) Physician |
| 931 | NE | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ascension Medical Group Via Christi, PA | Current | Accepting new patients | |
| Ascension Medical Group Via Christi, PA | Current | Accepting new patients | |
| Ascension Medical Group Via Christi, PA | Past | Accepting new patients | |
| Ear, Nose & Throat Associates, P.C. | Otolaryngology | Past | Accepting new patients |
Locations
1947 N Founders Cir
Wichita, KS 67206
Phone (316) 613-4640
3311 E Murdock St
Wichita, KS 67208
Phone (316) 689-9107
Organizations & group practices 4
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.
-
- Multi-Specialty Clinic/Center
- Wichita, KS
- NPI 1063453991
-
- Rural Health Clinic/Center
- Wellington, KS
- NPI 1538773569
-
dba Ascension Via Christi Surgery Center
- Ambulatory Surgical Clinic/Center
- Wichita, KS
- NPI 1073523452
-
dba Norfolk Ear, Nose & Throat, P.C.
- Otolaryngology Physician
- Norfolk, NE
- NPI 1477664514
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Wichita, KS
- NPI 1023334950
-
- General Acute Care Hospital
- Wichita, KS
- NPI 1154314789
-
- Rehabilitation Hospital
- Wichita, KS
- NPI 1083604789
Inpatient rehabilitation facility
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1435708800000",
"number": "1932356078",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8035",
"city": "WICHITA",
"state": "KS",
"postal_code": "672080035",
"telephone_number": "316-689-9135",
"fax_number": "316-689-9769"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1947 N FOUNDERS CIR",
"city": "WICHITA",
"state": "KS",
"postal_code": "672063548",
"telephone_number": "316-613-4680",
"fax_number": "316-613-4906"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "SHAUNDA",
"middle_name": "MARIE",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-20",
"last_updated": "2015-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "NE",
"license": "931",
"primary": false
},
{
"code": "207YX0007X",
"taxonomy_group": "",
"desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
"state": "PA",
"license": "OTO12165",
"primary": false
},
{
"code": "207YX0007X",
"taxonomy_group": "",
"desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
"state": "KS",
"license": "05-38208",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wichita, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2015; 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.