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RANDY RICHARD RODRIGUEZ PA-C, MS
NPI 1043868870
Physician Assistant - Medical in San Diego, CA

Active since August 26, 2019PECOS EnrolledAccepts Medicare Assignment
721 S 28TH ST, SAN DIEGO, CA 92113(619) 515-2324 Get Directions Write a Review

NPPES record last updated: April 3, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Apr 3, 2026, Feb 18, 2025, Feb 10, 2022 and 2 more (5 updates tracked since 2019).

About Randy Richard Rodriguez Pa-c, Ms NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RANDY RICHARD RODRIGUEZ PA-C, MS (NPI 1043868870) is an individual medical provider in San Diego, California, licensed in California (57456) and active in the NPI registry since August 2019. He is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1043868870
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameRANDY RICHARD RODRIGUEZCredential: PA-C, MS
Location Address721 S 28TH STSan Diego, CA 92113-2113
Mailing Address823 Gateway Center WaySan Diego, CA 92102-4541 · (619) 906-4623
Phone(619) 515-2324
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateAugust 26, 2019
Last NPPES UpdateApril 3, 20265 updates tracked since enumeration
NPPES CertifiedApril 3, 2026
✔ NPI 1043868870 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in CA · 57456
Also ListedPhysician AssistantTaxonomy 363A00000X
721 S 28TH ST, San Diego, CA 92113
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Randy Richard Rodriguez Pa-c, Ms is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9931533981
PECOS Enrollment IDI20191227000572
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Randy Rodriguez's NPI number?

The NPI number for Randy Rodriguez is 1043868870. It was assigned to this individual provider in the NPPES registry on August 26, 2019.

Where is Randy Rodriguez located?

Randy Rodriguez practices at 721 S 28th St, San Diego, CA 92113. The listed phone number is (619) 515-2324.

What is Randy Rodriguez's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Randy Rodriguez enrolled in Medicare?

Yes. Randy Rodriguez is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Randy Rodriguez was last updated on April 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.