| Mr Benjamin R Rodriguez, MMS, PA-C | |
|
1420 Ahtanum Ridge Dr, Union Gap, WA 98903-1839 | |
| (509) 454-7700 | |
| (509) 454-7710 |
| Full Name | Mr Benjamin R Rodriguez |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 17 Years |
| Location | 1420 Ahtanum Ridge Dr, Union Gap, Washington |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588998645 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA.PA.60108079 (Washington) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Astria Sunnyside Hospital | Sunnyside, WA | Hospital |
| Yakima Valley Memorial | Yakima, WA | Hospital |
| Astria Toppenish Hospital | Toppenish, WA | Hospital |
| Kittitas Valley Community Hospital | Ellensburg, WA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Shc Medical Center Toppenish | 4082980065 | 43 |
| Sunnyside Community Hospital Association | 1658280896 | 57 |
| Entity Name | Sunnyside Community Hospital Association |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1225033814 PECOS PAC ID: 1658280896 Enrollment ID: O20030317000038 |
| Entity Name | Sunnyside Community Hospital Association |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1679521637 PECOS PAC ID: 1658280896 Enrollment ID: O20040227000194 |
| Entity Name | Shc Medical Center Toppenish |
|---|---|
| Entity Type | Part B Supplier - Hospital Department(s) |
| Entity Identifiers | NPI Number: 1851817308 PECOS PAC ID: 4082980065 Enrollment ID: O20171018001921 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Benjamin R Rodriguez, MMS, PA-C Po Box 719, Sunnyside, WA 98944-0719 Ph: (509) 837-1617 | Mr Benjamin R Rodriguez, MMS, PA-C 1420 Ahtanum Ridge Dr, Union Gap, WA 98903-1839 Ph: (509) 454-7700 |