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DR. LUKE J RODRIGUEZ MD
NPI 1497285142
Surgery in Pottsville, PA

Active since June 15, 2017PECOS EnrolledAccepts Medicare Assignment
95.2/100
CMS Quality Rating
171 RED HORSE RD, POTTSVILLE, PA 17901(104) 027-8846 Get Directions Write a Review

NPPES record last updated: October 3, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 3, 2023, Aug 29, 2023, Jun 15, 2017 (3 updates tracked since 2017).

About Dr. Luke J Rodriguez Md NPPES

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

DR. LUKE J RODRIGUEZ MD (NPI 1497285142) is an individual surgery provider in Pottsville, Pennsylvania, licensed in Pennsylvania (MD482480) and active in the NPI registry since June 2017. He is enrolled in Medicare PECOS, is affiliated with Schuylkill Medical Center - South Jackson Street, and maintains a secondary practice location in Allentown.

NPPES Registry Identity

NPI1497285142
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameDR. LUKE J RODRIGUEZCredential: MD
Location Address171 RED HORSE RDPottsville, PA 17901-9119
Mailing Address2100 Mack Blvd Fl 4Allentown, PA 18103-5622
Phone(104) 027-8846
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateJune 15, 2017
Last NPPES UpdateOctober 3, 20233 updates tracked since enumeration
NPPES CertifiedOctober 3, 2023
✔ NPI 1497285142 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
Licenses✔ Licensed in PA · MD482480✔ Licensed in PA · MT214071
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
171 RED HORSE RD, Pottsville, PA 17901
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Secondary Practice Location 1

Location 11240 S Cedar Crest Blvd Ste 410Allentown, PA 18103-6218 · Phone (610) 402-7884

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware.Insurance ›

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

Dr. Luke J Rodriguez 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 ID9537430640
PECOS Enrollment IDI20230913000547
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.

Areas of Expertise CMS Part B claims 9

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Partial removal of breast 19301
A partial removal of the breast, also known as a lumpectomy, involves taking out a portion of the breast tissue to eliminate concerning cells. It's typically performed when the problem area is limited in size. This procedure helps to preserve most of the breast's appearance while aiming to remove all the unhealthy cells.
34 services32 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
27 services27 patients
Biopsy or removal of deep lymph nodes of underarm 38525
A biopsy or removal of deep underarm lymph nodes is a procedure where a small sample of lymph node tissue is taken for testing. This helps in diagnosing or ruling out conditions like infections or cancers. It involves a small incision and is typically done under local or general anesthesia.
22 services22 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
22 services21 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
19 services19 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
16 services16 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Schuylkill Medical Center - South Jackson Street

Acute Care Hospitals · Pottsville, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390030
Location420 South Jackson StreetPottsville, PA 17901 · Schuylkill County
Emergency services Birthing friendly

Lehigh Valley Hospital

Acute Care Hospitals · Allentown, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390133
Location1200 South Cedar Crest BoulevardAllentown, PA 18103 · Lehigh County
Emergency services Birthing friendly

Lehigh Valley Hospital - Hazleton

Acute Care Hospitals · Hazleton, PA
3/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number390185
Location700 East Broad StreetHazleton, PA 18201 · Luzerne County
Emergency services Birthing friendly

Lehigh Valley Hospital - Pocono

Acute Care Hospitals · East Stroudsburg, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390201
Location206 East Brown StreetEast Stroudsburg, PA 18301 · Monroe County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 17901 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
$84.88 typical visit price
range $54.64 – $166.87
Typical copayment $21.22 (range $13.66 – $41.71)
Most-billed visit code 99203
Established Patient
$68.36 typical visit price
range $17.33 – $135.84
Typical copayment $17.09 (range $4.33 – $33.96)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

95.2/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality85.76
Promoting Interoperability96
Improvement Activities40

Other Providers at the Same Location NPPES 9

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

COMPREHENSIVE WOMEN'S HEALTH SERVICES, P.C.
Obstetrics & Gynecology
171 RED HORSE RD
POTTSVILLE, PA 17901
Schuylkill County (570) 628-2229
DR. DAVID PAUL KREWSON D.O.
Obstetrics & Gynecology
171 RED HORSE RD
POTTSVILLE, PA 17901
Schuylkill County (570) 628-2229
DR. ROBERT MILES ZIMMERMAN JR. D.O.
Obstetrics & Gynecology
171 RED HORSE RD
POTTSVILLE, PA 17901
Schuylkill County (570) 628-2229
JAMES C XENOPHON MD
Obstetrics & Gynecology
171 RED HORSE RD
POTTSVILLE, PA 17901
Schuylkill County (570) 628-2229
REBECCA SPOTTS CRNP
Nurse Practitioner (Family)
171 RED HORSE RD
POTTSVILLE, PA 17901
Schuylkill County (570) 628-2229
ASHLEY COSTA M.D.
Obstetrics & Gynecology
171 RED HORSE RD
POTTSVILLE, PA 17901
Schuylkill County (570) 628-2229
MRS. HEATHER GOSCH C.N.M.
Advanced Practice Midwife
171 RED HORSE RD
POTTSVILLE, PA 17901
Schuylkill County (570) 628-2229
BARBARA KEISER TRIEBEL CRNP
Nurse Practitioner (Obstetrics & Gynecology)
171 RED HORSE RD
POTTSVILLE, PA 17901
Schuylkill County (570) 628-2229

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 Luke Rodriguez's NPI number?

The NPI number for Luke Rodriguez is 1497285142. It was assigned to this individual provider in the NPPES registry on June 15, 2017.

Where is Luke Rodriguez located?

Luke Rodriguez practices at 171 Red Horse Rd, Pottsville, PA 17901. The listed phone number is (104) 027-8846.

What is Luke Rodriguez's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Luke Rodriguez enrolled in Medicare?

Yes. Luke 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.

What insurance does Luke Rodriguez accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Luke Rodriguez as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Luke Rodriguez affiliated with any hospitals?

According to CMS data, Luke Rodriguez is affiliated with Schuylkill Medical Center - South Jackson Street, Lehigh Valley Hospital, Lehigh Valley Hospital - Hazleton and Lehigh Valley Hospital - Pocono.

When was this NPI record last updated?

The NPPES record for Luke Rodriguez was last updated on October 3, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.