ADELINO JOSE RODRIGUEZ ROCHA MD
NPI 1891365656
Family Medicine in York, PA

NPI Status: Active since June 24, 2021

Contact Information

1001 S GEORGE ST
YORK, PA
ZIP 17403
Phone: (717) 851-2521

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  • Individual
  • Male
  • Years of Experience 14
  • Family Medicine
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About ADELINO RODRIGUEZ ROCHA

This page provides the complete NPI Profile along with additional information for Adelino Rodriguez Rocha, a primary care provider established in York, Pennsylvania with a medical specialization in Family Medicine and more than 14 years of experience. The healthcare provider is registered in the NPI registry with number 1891365656 assigned on June 2021. The practitioner's primary taxonomy code is 207Q00000X with license number MT223073 (PA). The provider is registered as an individual and his NPI record was last updated 5 years ago.

NPI
1891365656
Provider Name
ADELINO JOSE RODRIGUEZ ROCHA MD
Gender
Male
Entity Type
Individual
Location Address
1001 S GEORGE ST YORK, PA 17403
Location Phone
(717) 851-2521
Mailing Address
1001 S GEORGE ST YORK, PA 17403
Medical School Name
OTHER
Graduation Year
2012
Is Sole Proprietor?
No
Enumeration Date
06-24-2021
Last Update Date
06-24-2021
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A primary care provider (PCP) like Adelino Rodriguez Rocha sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

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

Family Medicine

Taxonomy Code
207Q00000X
Type
Allopathic & Osteopathic Physicians
License No.
MT223073
License State
PA
Taxonomy Description
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Standard Expanded Bronze - HMO
  • Standard Gold - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Clear Silver with $0 Insulin Options - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Gold with Atrium Health - HMO
  • Complete Gold with Atrium Health + Vision + Adult Dental - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Elite Bronze with Atrium Health - HMO
  • Elite Bronze with Atrium Health + Vision + Adult Dental - HMO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options - HMO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Blue Advantage Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | Nationwide Doctors - PPO
  • Blue Advantage Bronze Complete | $60 PCP | $20 Tier 1 Rx | Nationwide Doctors - PPO
  • Blue Advantage Bronze HSA Eligible | Integrated | Nationwide Doctors - PPO
  • Blue Advantage Bronze Standard | Nationwide Doctors - PPO
  • Blue Advantage Gold Premier A | 3 Free PCP | $10 Tier 1 Rx | Nationwide Doctors - PPO
  • Blue Advantage Gold Standard A | Nationwide Doctors - PPO
  • Blue Advantage Silver Choice A | 3 Free PCP | $15 Tier 1 Rx | Nationwide Doctors - PPO
  • Blue Advantage Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | Nationwide Doctors - PPO
  • Blue Advantage Silver Standard | Nationwide Doctors - PPO
  • Blue Care Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | Statewide Doctors - HMO
  • Blue Direction Bronze 1 - POS
  • Blue Direction Silver 1 - POS
  • Blue Direction Silver 1 + Adult Vision - POS
  • Blue Direction Silver 2 - POS
  • Blue Direction Standard Expanded Bronze - POS
  • Blue Direction Standard Gold - POS
  • Blue Direction Standard Silver - POS
  • Blue VirtuConnect Bronze 1 - EPO
  • Blue VirtuConnect Gold 1 - EPO
  • Blue VirtuConnect Silver 1 - EPO
  • InHealth Basic 1 - HMO
  • InHealth Basic 1 + Adult Vision - HMO
  • InHealth Basic 2 - HMO
  • InHealth Basic Plus Standard - HMO
  • InHealth Basic Standard - HMO
  • Bronze Classic 4700 - HMO
  • Bronze Classic 4700 | with Atrium Health - HMO
  • Bronze Classic Standard - HMO
  • Bronze Classic Standard | with Atrium Health - HMO
  • Bronze Elite + PCP Saver Plus - HMO
  • Bronze Elite + PCP Saver Plus | with Atrium Health - HMO
  • Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health - HMO
  • Bronze Simple Chronic Care CKM | with Atrium Health - HMO
  • Bronze Simple Diabetes | with Atrium Health - HMO
  • Gold Classic Standard - HMO
  • UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
  • UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals - HMO
  • UHC Bronze Standard (No Referrals) - HMO
  • UHC Bronze Standard+ Dental + Vision (No Referrals) - HMO
  • UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals) - HMO
  • UHC Gold Advantage + ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
  • UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
  • UHC Gold Standard (No Referrals) - HMO
  • UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
  • UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Adelino Rodriguez Rocha 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.

Adelino Rodriguez Rocha 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: 9739581729

    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: I20241108001556

    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

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $21.22 for a new patient copayment and $24.2 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 17403 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $84.88
  • Minimum New Patient Price $54.64
  • Maximum New Patient Price $166.87
  • Average New Patient Copayment $21.22
  • Minimum New Patient Copayment $13.66
  • Maximum New Patient Copayment $41.71

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $96.82
  • Minimum Established Patient Price $17.33
  • Maximum Established Patient Price $135.84
  • Average Established Patient Copayment $24.2
  • Minimum Established Patient Copayment $4.33
  • Maximum Established Patient Copayment $33.96

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Find 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. Adelino Rodriguez Rocha is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
CAROLINAS MEDICAL CENTER/BEHAV HEALTH1000 BLYTHE BLVD
CHARLOTTE, NC 28203
(704) 355-2000Acute Care Hospitals

Reviews for ADELINO JOSE RODRIGUEZ ROCHA MD

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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 1891365656, we treat the final digit (6) 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 64. The final step is to find the difference between that total and the next multiple of ten (70 - 64 = 6).

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.

Pos 1
1
Doubled → 2
Pos 2
8
Unchanged
Pos 3
9
Doubled → 18 → 1 + 8
Pos 4
1
Unchanged
Pos 5
3
Doubled → 6
Pos 6
6
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
6
Unchanged
Pos 9
5
Doubled → 10 → 1 + 0
Check
6
Target digit
Regular digit Doubled digit Check digit

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.

1 → 2 9 → 18 → 9 3 → 6 5 → 10 → 1 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 8 + 1 + 8 + 1 + 6 + 6 + 1 + 0 + 6 + 1 + 0 + 24 = 64

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 64 is 70. The difference is the calculated check digit.

70 - 64 = 6
This NPI is valid
The calculated check digit is 6, which matches the last digit of 1891365656.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Pharmacist (Pharmacotherapy)
1001 S GEORGE ST
YORK, PA 17403
Radiology (Diagnostic Radiology)
1001 S GEORGE ST
YORK, PA 17403
Radiology (Diagnostic Radiology)
1001 S GEORGE ST
YORK, PA 17403
Pathology (Anatomic Pathology & Clinical Pathology)
1001 S GEORGE ST
YORK, PA 17403
Internal Medicine (Infectious Disease)
1001 S GEORGE ST, MKB 4TH FLR
YORK, PA 17403
Internal Medicine (Infectious Disease)
1001 S GEORGE ST, 4TH FLOOR KETTERMAN BUILDING
YORK, PA 17403
Anesthesiology
1001 S GEORGE ST
YORK, PA 17403
Anesthesiology
1001 S GEORGE ST
YORK, PA 17403
Anesthesiology
1001 S GEORGE ST
YORK, PA 17403
Anesthesiology
1001 S GEORGE ST
YORK, PA 17403
Anesthesiology
1001 S GEORGE ST
YORK, PA 17403
Anesthesiology
1001 S GEORGE ST
YORK, PA 17403
Anesthesiology
1001 S GEORGE ST
YORK, PA 17403
Nurse Anesthetist, Certified Registered
1001 S GEORGE ST
YORK, PA 17403
Anesthesiology
1001 S GEORGE ST
YORK, PA 17403
Anesthesiology
1001 S GEORGE ST
YORK, PA 17403
Nurse Anesthetist, Certified Registered
1001 S GEORGE ST
YORK, PA 17403
Nurse Anesthetist, Certified Registered
1001 S GEORGE ST
YORK, PA 17403
Anesthesiology
1001 S GEORGE ST
YORK, PA 17403
Anesthesiology
1001 S GEORGE ST
YORK, PA 17403

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1891365656, enumerated as an "individual" on June 24, 2021.

The provider is located at 1001 S GEORGE ST YORK, PA 17403 and the phone number is (717) 851-2521.

Family Medicine with taxonomy code 207Q00000X.

The provider might be accepting Accepts: Ambetter from Absolute Total Care, Ambetter of. Please consult your insurance carrier or call the provider to verify.

Adelino Rodriguez Rocha is affiliated with: CAROLINAS MEDICAL CENTER/BEHAV HEALTH.