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DIANE VIDAL RODRIGUEZ
NPI 1205648904
Nurse Practitioner - Psychiatric/Mental Health in San Jose, CA

Active since January 21, 2025PECOS EnrolledAccepts Medicare Assignment
675 N 1ST ST PH 3, SAN JOSE, CA 95112(562) 985-4111 Get Directions Write a Review

NPPES record last updated: September 19, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Diane Vidal Rodriguez NPPES

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

DIANE VIDAL RODRIGUEZ (NPI 1205648904) is an individual psychiatric/mental health provider in San Jose, California, licensed in California (95031722) and active in the NPI registry since January 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1205648904
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameDIANE VIDAL RODRIGUEZ
Location Address675 N 1ST ST PH 3San Jose, CA 95112-5112
Mailing Address675 N 1st St Ph 3San Jose, CA 95112-5112
Phone(562) 985-4111
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateJanuary 21, 2025
Last NPPES UpdateSeptember 19, 2025
NPPES CertifiedSeptember 19, 2025
✔ NPI 1205648904 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in CA · 95031722
675 N 1ST ST PH 3, San Jose, CA 95112
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Diane Vidal Rodriguez 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 ID9335661412
PECOS Enrollment IDI20250318002524
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.

Medicare Billing Reassignment

Medicare enrollment records show Diane Rodriguez reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Piedmont Interventional Psychiatry PC
Same address
Psychiatry
675 N 1ST ST PH 3
San Jose, CA 95112
  • Reassigned Medicare billing, California enrollment
  • 4 clinicians in this Medicare group
NPI 1912728767 (831) 512-3090

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95112 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$106.47 typical visit price
range $70.37 – $206.04
Typical copayment $26.61 (range $17.59 – $51.51)
Most-billed visit code 99203
Established Patient
$121.77 typical visit price
range $23.96 – $169.60
Typical copayment $30.44 (range $5.99 – $42.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

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

DR. AKASH JAGGI MD
Psychiatry & Neurology (Psychiatry)
675 N 1ST ST PH 3
SAN JOSE, CA 95112
Santa Clara County (831) 512-3090
PIEDMONT INTERVENTIONAL PSYCHIATRY PC
Psychiatry & Neurology (Psychiatry)
675 N 1ST ST PH 3
SAN JOSE, CA 95112
Santa Clara County (831) 512-3090

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 Diane Rodriguez's NPI number?

The NPI number for Diane Rodriguez is 1205648904. It was assigned to this individual provider in the NPPES registry on January 21, 2025.

Where is Diane Rodriguez located?

Diane Rodriguez practices at 675 N 1st St Ph 3, San Jose, CA 95112. The listed phone number is (562) 985-4111.

What is Diane Rodriguez's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Diane Rodriguez enrolled in Medicare?

Yes. Diane 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.

Which organization bills Medicare for Diane Rodriguez's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Diane Rodriguez reassigns Medicare benefits to Piedmont Interventional Psychiatry PC (San Jose, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Diane Rodriguez's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Diane Rodriguez was last updated on September 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.