Derek L Rodigo

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

9024 Issued in ID

Practice address

809 S Washington Ave
Emmett, ID 83617-3528

Phone

(208) 365-5341

Fax

(208) 365-5342

NPI assigned

May 9, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peak Physical Therapy P CGroup PAC ID 7012977168, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Peak Physical Therapy P C

  • Physical Therapist
  • Boise, ID
  • NPI 1073551560
  Medicare reassignment Care Compare group NPD
• Gem Rehabilitation Services, Inc.

  • Physical Therapist
  • Horseshoe Bend, ID
  • NPI 1730219361
  NPD (past)
• Institute of Physical Therapy and Fitness

  • Physical Therapist
  • Lewiston, ID
  • NPI 1043392087
  NPD (past)

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

{
    "created_epoch": "1715212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1942058417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 LYNDON FARM CT STE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402235005",
            "telephone_number": "726-202-3039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 S WASHINGTON AVE",
            "city": "EMMETT",
            "state": "ID",
            "postal_code": "836173528",
            "telephone_number": "208-365-5341",
            "fax_number": "208-365-5342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODIGO",
        "first_name": "DEREK",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-09",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "9024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patty Ann Puschmann, BI
• Redefined Counseling and Consulting
• Marjorie Colleen Reed, IS
• Desiree Darlene Reid, PA-C
• Kirk Robbins
• Kimberly M Roller
• Shon Dewane Rooks, D.D.S.
• Morgan Riley Ruiz, DO
• Brandon Scott Sallee
• Andrew Dean Sapp, PH.D.

• Physical Therapist in Emmett, ID
• Providers in Emmett, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.