Provider Type Icon

JOSE ILDEFONSO RODRIGUEZ MORENO M.D. NPI 1891148854


NPI Information

NPI: 1891148854
Provider Name: JOSE ILDEFONSO RODRIGUEZ MORENO, M.D.
Classification: Psychiatry & Neurology - 2084N0400X
Entity Type: Individual

Specialization: Neurology

PECOS Registration: Yes

Address:
2900 STATE ST STE 101
MEDFORD, OR
ZIP 97504
Phone: (541) 789-5790
Get Directions

Jose Ildefonso Rodriguez Moreno, M.D. is a neurology psychiatry neurology in Medford, OR with 7 years of experience. The provider is a Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. Jose Ildefonso Rodriguez Moreno, M.D. NPI is 1891148854. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2900 STATE ST STE 101
MEDFORD, OR
ZIP 97504-458
Phone: (541) 789-5790

The NPI 1891148854 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/14/2016 and was last updated on 7/14/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12084N0400XPsychiatry & NeurologyNeurologyMD202077OREGONYes
22084N0402XPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology267707MASSACHUSETTSNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.