Dr Olaf Rodriguez, MD is a medicare enrolled "Dermatology" physician in Urbana, Illinois. His current practice location is
1111 W Kenyon Rd, Urbana, Illinois. You can reach out to his office (for appointments etc.) via phone at
(217) 819-3376.
Dr Olaf Rodriguez is licensed to practice in Illinois (license number 036171478) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1144780594.
Physician's Profile
| Full Name | Dr Olaf Rodriguez |
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| Gender | Male |
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| Speciality | Dermatology |
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| Location | 1111 W Kenyon Rd, Urbana, Illinois |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1144780594
- Provider Enumeration Date: 03/21/2019
- Last Update Date: 01/29/2025
Medicare PECOS Information:
- PECOS PAC ID: 8224451661
- Enrollment ID: I20240919000178
Medical Identifiers
Medical identifiers for Dr Olaf Rodriguez such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1144780594 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207ND0900X | Dermatology - Dermatopathology | 036171478 (Illinois) | Secondary |
| 207N00000X | Dermatology | 036171478 (Illinois) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Olaf Rodriguez allows following entities to bill medicare on his behalf.
| Entity Name | Vitalskin Medical Group Il Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1063030252
PECOS PAC ID: 5991116261
Enrollment ID: O20201118002083 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Olaf Rodriguez is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Olaf Rodriguez, MD
1111 W Kenyon Rd,
Urbana, IL 61801-1004
Ph: () - | Dr Olaf Rodriguez, MD
1111 W Kenyon Rd,
Urbana, IL 61801-1004
Ph: (217) 819-3376 |
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