DAVID ANTHONY RODEBERG MD
NPI 1124120290
Surgery - Pediatric Surgery in Greenville, NC

Q: What is David Rodeberg's NPI number?

The NPI number for David Rodeberg is 1124120290. It was assigned to this individual provider in the NPPES registry on September 1, 2006.

Q: What is David Rodeberg's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Pediatric Surgery, with taxonomy code 2086S0120X.

Q: When was this NPI record last updated?

The NPPES record for David Rodeberg was last updated on April 5, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since September 01, 2006PECOS EnrolledAccepts Medicare Assignment

517 MOYE BLVD, GREENVILLE, NC 27834(252) 744-2832(252) 744-3457 Get Directions Write a Review

NPPES record last updated: April 5, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 5, 2022, Dec 17, 2020 (2 updates tracked since 2020).

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About David Anthony Rodeberg Md NPPES

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

DAVID ANTHONY RODEBERG MD (NPI 1124120290) is an individual pediatric surgery provider in Greenville, North Carolina, licensed in North Carolina (2010-00640) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS, maintains a secondary practice location in Lexington, and is a graduate of University Of Wisconsin School Of Medicine (1989).

NPPES Registry Identity

NPI1124120290

Entity TypeIndividualMale

Primary Taxonomy2086S0120X

Provider Legal NameDAVID ANTHONY RODEBERGCredential: MD

Location Address517 MOYE BLVDGreenville, NC 27834-2849

Mailing AddressPo Box 751069Charlotte, NC 28275-1069

Phone(252) 744-2832

Fax(252) 744-3457

Sole ProprietorNo

Medical School CMSUniversity Of Wisconsin School Of MedicineGraduated 1989

Enumeration DateSeptember 1, 2006

Last NPPES UpdateApril 5, 20222 updates tracked since enumeration

NPPES CertifiedApril 5, 2022

✔ NPI 1124120290 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Pediatric SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code2086S0120X

Licenses✔ Licensed in NC · 2010-00640✔ Licensed in PA · MD429509✔ Licensed in KY · TP683

Definition

A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents.

517 MOYE BLVD, Greenville, NC 27834

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Secondary Practice Location 1

Location 1740 S LimestoneLexington, KY 40536-2849 · Phone (859) 218-2588 · Fax (859) 323-3918

Other Identifiers 2

Other158YPNC · Bcbsnc

Medicaid5914874NC

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

David Anthony Rodeberg Md 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 ID9537168653

PECOS Enrollment IDI20220512002805

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.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HEIDI KENEFICK DO

Pediatrics