RAFAEL DE JESUS PEREZ RODRIGUEZ MD
NPI 1750732863
Psychiatry & Neurology - Epilepsy
in Eau Claire, WI
NPI Status: Active since June 29, 2016
Contact Information
1400 BELLINGER ST
EAU CLAIRE, WI
ZIP 54703
Phone: (715) 838-5222
- Individual
- Male
- Years of Experience 13
- Psychiatry & Neurology
- Epilepsy
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About RAFAEL PEREZ RODRIGUEZ
This page provides the complete NPI Profile along with additional information for Rafael Perez Rodriguez, a provider established in Eau Claire, Wisconsin with a medical specialization in Psychiatry & Neurology, focusing in epilepsy and more than 13 years of experience. The healthcare provider is registered in the NPI registry with number 1750732863 assigned on June 2016. The practitioner's primary taxonomy code is 2084E0001X with license number 76752 (WI). The provider is registered as an individual and his NPI record was last updated 2 years ago.
- NPI
- 1750732863
- Provider Name
- RAFAEL DE JESUS PEREZ RODRIGUEZ MD
- Other Name
- RAFAEL PEREZ RODRIGUEZ MD
- Other Name Type
- Professional Name (2)
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1400 BELLINGER ST EAU CLAIRE, WI 54703
- Location Phone
- (715) 838-5222
- Mailing Address
- 200 1ST ST SW ROCHESTER, MN 55905
- Medical School Name
- OTHER
- Graduation Year
- 2013
- Is Sole Proprietor?
- No
- Enumeration Date
- 06-29-2016
- Last Update Date
- 07-30-2024
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Psychiatry & Neurology Epilepsy
- Taxonomy Code
- 2084E0001X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 76752
- License State
- WI
- Taxonomy Description
- Epilepsy is a subspecialty of neurology focused on the diagnosis and treatment of patients with epilepsy, including new-onset, medically refractory epilepsy, psychogenic nonepileptic seizures, and epilepsy in special populations (the elderly, women, patients with co-morbidities). Epilepsy is a multidisciplinary field that provides comprehensive care of the patient.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 2084N0400X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | 008452 (GA) |
| 2 | 2084N0400X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | 76752 (WI) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Preferred/Broad HSA (+ Incentives) - POS
- Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Gold Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Gold Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Heart Healthy Bronze Preferred/Broad 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - POS
- Anthem Silver Preferred/Broad 4000 ($0 PCP Visits + $0 Select Drugs + Incentives) - POS
- Anthem Silver Preferred/Broad 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Silver Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Engage by Medica Bronze HSA - EPO
- Engage by Medica Bronze Share - EPO
- Engage by Medica Expanded Bronze Standard - EPO
- Engage by Medica Gold $0 Copay PCP Visits - EPO
- Engage by Medica Gold Share - EPO
- Engage by Medica Gold Standard - EPO
- Engage by Medica Silver $0 Copay PCP Visits - EPO
- Engage by Medica Silver Share - EPO
- Engage by Medica Silver Standard - EPO
- Medica Individual Choice Bronze $0 Copay PCP Visits - HMO
- Medica Individual Choice Bronze HSA - EPO
- Medica Individual Choice Bronze Share - EPO
- Medica Individual Choice Bronze Share - HMO
- Medica Individual Choice Expanded Bronze Standard - EPO
- Medica Individual Choice Expanded Bronze Standard - HMO
- Medica Individual Choice Gold $0 Copay PCP Visits - EPO
- Medica Individual Choice Gold $0 Copay PCP Visits - HMO
- Medica Individual Choice Gold Share - EPO
- Medica Individual Choice Gold Share - HMO
- Medica Individual Choice Gold Standard - EPO
- Premier $2,000 - 25% - HMO
- Premier $3,500 - 30% - HMO
- Premier $4,000 - 50% - HMO
- Premier $5,000 HDHP - HMO
- Premier $6,000 - 40% - HMO
- Premier $7,500 - HMO
- Premier $7,500 HDHP - HMO
- Premier HMO $1,500 - 30% - HMO
- Premier HMO $2,500 - 20% Copay - HMO
- Premier HMO $3,400 - 30% HDHP - HMO
- Premier HMO $3,500 - 30% - HMO
- Premier HMO $3,500 HDHP - HMO
- Premier HMO $4,000 - 20% HDHP - HMO
- Premier HMO $5,000 - 20% HDHP - HMO
- Premier HMO $5,500 - 40% Copay - HMO
- Premier HMO $7,500 HDHP - HMO
- Premier HMO $750 - 10% - HMO
- Premier HMO $9,500 - HMO
- Premier POS $1,500 - 30% - POS
- Premier POS $2,500 - 20% Copay - POS
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Rafael Perez Rodriguez is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Rafael Perez Rodriguez is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 2365824448
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20220805002104
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Established patient office or other outpatient visit, 30-39 minutes
Follow-up hospital inpatient care per day, typically 35 minutes
Measurement of brain wave activity (eeg), 41-60 minutes
Measurement of brain wave activity (eeg), awake and asleep
Measurement of brain wave activity (eeg), awake and drowsy
New patient office or other outpatient visit, 45-59 minutes
New patient office or other outpatient visit, 60-74 minutes
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
This service was performed 17 times for 16 patientsFollow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
This service was performed 21 times for 12 patientsThis procedure involves placing small sensors on your head to record your brain's electrical activity for 41-60 minutes. Known as an EEG, it helps doctors understand how your brain works, assisting in diagnosing conditions like epilepsy or sleep disorders.
This service was performed 23 times for 23 patientsThe measurement of brain wave activity, known as an EEG, records the brain's electrical signals. It's performed when you're awake and asleep to monitor your brain's functioning. It helps in diagnosing conditions like epilepsy, sleep disorders, and other neurological issues.
This service was performed 12 times for 12 patientsMeasurement of brain wave activity, also known as an EEG, is a non-invasive test that records electrical patterns in your brain. This procedure is done when you're awake and drowsy to understand how your brain functions during different states of consciousness.
This service was performed 22 times for 22 patientsThis 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.
This service was performed 29 times for 29 patientsThis is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
This service was performed 25 times for 25 patientsFind Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Rafael Perez Rodriguez is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| MAYO CLINIC HEALTH SYSTEM EAU CLAIRE HOSPITAL | 1221 WHIPPLE ST EAU CLAIRE, WI 54703 | (715) 838-3311 | Acute Care Hospitals | |
| MAYO CLINIC HEALTH SYSTEM CHIPPEWA VALLEY | 1501 THOMPSON ST BLOOMER, WI 54724 | (715) 568-2000 | Critical Access Hospitals | |
| MAYO CLINIC HEALTH SYSTEM-NORTHLAND | 1222 E WOODLAND AVE BARRON, WI 54812 | (715) 537-3186 | Critical Access Hospitals | |
| MAYO CLINIC HEALTH SYSTEM-RED CEDAR INC | 2321 STOUT RD MENOMONIE, WI 54751 | (715) 233-7444 | Critical Access Hospitals |
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1750732863, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 57. The final step is to find the difference between that total and the next multiple of ten (60 - 57 = 3).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 57 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
EAU CLAIRE, WI 54703
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1750732863, enumerated as an "individual" on June 29, 2016.
The provider is located at 1400 BELLINGER ST EAU CLAIRE, WI 54703 and the phone number is (715) 838-5222.
Psychiatry & Neurology with taxonomy code 2084E0001X and a focus in Epilepsy .
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Medica and. Please consult your insurance carrier or call the provider to verify.
Rafael Perez Rodriguez is affiliated with: MAYO CLINIC HEALTH SYSTEM EAU CLAIRE HOSPITAL, MAYO CLINIC HEALTH SYSTEM CHIPPEWA VALLEY, MAYO CLINIC HEALTH SYSTEM-NORTHLAND and MAYO CLINIC HEALTH SYSTEM-RED CEDAR INC.