Individual provider Active NPI

Charles Dale Rhodus, DPM

  • Podiatrist
  • Tyler, TX
National Provider Identifier
1962495341
Registry record updated Jun 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
1375 Issued in TX
Practice address
5826 New Copeland Rd
Tyler, TX 75703-6217
Phone
(903) 592-7200
Fax
(903) 592-7211
NPI assigned
Aug 31, 2005
Last updated
Jun 21, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 1375 TX Primary

Addresses

Primary practice location

5826 New Copeland Rd
Tyler, TX 75703-6217

Mailing address

5826 New Copeland Rd
Tyler, TX 75703-6217
Phone (903) 592-7200

Other identifiers 4

IdentifierTypeStateIssuer
161772848OtherTXCOMMERCIAL
8X2110OtherTXBCBS PIN
P00383164OtherTXMEDICARE RAILROAD
046291302MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070521000352 TX Practitioner - Podiatry 1153428495 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Foot Specialists of Tyler PAGroup PAC ID 1254438591, 2 clinicians

Practice addresses (Care Compare)

5826 New Copeland Rd
Tyler, TX 75703-6217
Phone (903) 592-7200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1219
Removal of skin lesions1-10
Removal of nail tissue303

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Foot Specialists of Tyler, PA Current Accepting new patients
Foot Specialists of Tyler, PA Podiatrist CurrentSince Jan 23, 2007 Accepting new patients

Locations

5826 New Copeland Rd
Tyler, TX 75703
Phone (903) 570-2473

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340236800000",
    "number": "1962495341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5826 NEW COPELAND RD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757036217",
            "telephone_number": "903-592-7200",
            "fax_number": "903-592-7211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5826 NEW COPELAND RD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757036217",
            "telephone_number": "903-592-7200",
            "fax_number": "903-592-7211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RHODUS",
        "first_name": "CHARLES",
        "middle_name": "DALE",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2012-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "TX",
            "license": "1375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL",
            "identifier": "161772848",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN",
            "identifier": "8X2110",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00383164",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046291302",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.