Crystal Marie Rodriguez · Crystal Marie Gleisner · Physician Assistant

5234 Sw Philomath Blvd, Corvallis, OR 97333-1042

Overview

Crystal Marie Rodriguez is a Physician Assistant practicing in Corvallis, Oregon. The National Provider Identifier (NPI) is #1780136242, which was assigned on November 1, 2016, and the registration record was last updated on March 17, 2023. The practitioner's main practice location is at 5234 Sw Philomath Blvd, Corvallis, OR 97333-1042; the contact telephone number is 5417684970. The primary taxonomy of Crystal Marie Rodriguez is Physician Assistant (363A00000X).

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Provider Information

NPI 1780136242
Entity Type Individual
Provider Name MRS. CRYSTAL MARIE RODRIGUEZ
Other Name CRYSTAL MARIE GLEISNER
(Former Name)
Gender Female
Credential PA-C
Other Credential PA-C
Practice Address 5234 Sw Philomath Blvd
Corvallis
OR 97333-1042
Practice Telephone 5417684970
Mailing Address Po Box 1189
Corvallis
OR 97339-1189
Certification Date 2023-03-17
Enumeration Date 2016-11-01
Last Update Date 2023-03-17
Is Sole Proprietor Y

Doctor and Clinician Information

PAC ID 4789965849
Medicare Provider Enrollment and Chain/Ownership System (PECOS) Associate Control (PAC) ID
Full Name CRYSTAL M RODRIGUEZ
Medical School GEORGE WASHINGTON UNIVERSITY SCHOOL OF MEDICINE
Primary Specialty PHYSICIAN ASSISTANT
Organization Legal Name GOOD SAMARITAN HOSPITAL CORVALLIS
Address 3600 Nw Samaritan Dr
Suite 227
Corvallis
OR 97330-3737

Taxonomy and Licenses

PrimaryCodeClassificationSpecializationTaxonomy GroupLicense NumberLicense State
Y363A00000XPhysician Assistant

Secondary Practice Locations

AddressTelephoneFax
5050 NE Hoyt St, Suite 240, Portland, OR 9721329915032156469

Providers with the same name

Provider NameAddressTaxonomyEnumeration Date
Crystal Marie Rodriguez 2001 Santa Monica Blvd, 890-W, Santa Monica, CA 90404-2102Mental Health Counselor2008-07-03

Taxonomy Information

Primary Taxonomy

Code 363A00000X
Taxonomy Physician Assistant
Classification Physician Assistant
Grouping Physician Assistants & Advanced Practice Nursing Providers
Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Providers with the same taxonomy

Provider NameAddressTaxonomyEnumeration Date
Magnificus Corporation Government Services 125a L Street, Se, Washington, DC 20003Physician Assistant2024-03-08
Amani Al-Halali 3600 Joseph Siewick Dr, Fairfax, VA 22033-1709Physician Assistant2024-03-08
Sydnee Rae Koneczny 1550 S Potomac St Ste 110, Aurora, CO 80012-5433Physician Assistant2024-03-08
Joanna George 4262 Mccaslin St, Pittsburgh, PA 15217-2829Physician Assistant2024-03-08
Jhocelyn Mesias 10 Plum St Fl 5, New Brunswick, NJ 08901-2066Physician Assistant2024-03-08
Kennedy Grovogel 8433 Harcourt Rd Ste 310, Indianapolis, IN 46260-2198Physician Assistant2024-03-07
Megan Schlesinger 1132 Cooper St, Woodbury, NJ 08096-3014Physician Assistant2024-03-07
Evan Michael Lins 101 7th St Sw, Orange City, IA 51041-1996Physician Assistant2024-03-07
Alexa Childs 1948 Three Farms Ave, Naperville, IL 60540-1105Physician Assistant2024-03-08
Sabrina Amato 144 Curtis St, Delaware, OH 43015-2466Physician Assistant2024-03-08
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Location Information

Street Address 5234 SW PHILOMATH BLVD
City CORVALLIS
State OR
Zip Code 97333-1042
Country US

Providers in the same location

Provider NameAddressTaxonomyEnumeration Date
Robin William Page-Echols 5234 Sw Philomath Blvd, Corvallis, OR 97333-1042Family Medicine Physician2010-06-22
Courtney A Strand 5234 Sw Philomath Blvd, Corvallis, OR 97333Family Nurse Practitioner2006-11-01
Tashina Louise Blair · Tashina Louise Martin 5234 Sw Philomath Blvd, Corvallis, OR 97333-1042Diabetes Educator Registered Nurse2021-09-02
Maximilian Schilling Kaiser 5234 Sw Philomath Blvd, Corvallis, OR 97333-1042Family Medicine Physician2013-06-13
Nancy J. Vanasche 5234 Sw Philomath Blvd, Corvallis, OR 97333-1042Registered Nurse2006-06-20
Mid-Valley Healthcare, Inc. · Samaritan Recovery Clinic Corvallis 5234 Sw Philomath Blvd Ste C, Corvallis, OR 97333-1042Pain Medicine Physician2017-06-26
Shanlee Pierson 5234 Sw Philomath Blvd Ste B, Corvallis, OR 97333-1042Family Nurse Practitioner2018-02-26
Timothy Ueng 5234 Sw Philomath Blvd, Corvallis, OR 97333-1042Family Medicine Physician2006-03-18
Brent C. Wesenberg 5234 Sw Philomath Blvd, Corvallis, OR 97333-1042Emergency Medicine Physician2006-05-27
Sandra Lynn Minta 5234 Sw Philomath Blvd, Corvallis, OR 97333-1042Mental Health Counselor2007-04-16
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Providers in the same zip code

Provider NameAddressTaxonomyEnumeration Date
Kathryn Elizabeth Taylor 5270 Sw Philomath Blvd, Corvallis, OR 97333-1042Pharmacist2011-12-11
Good Samaritan Hospital Corvallis · Samaritan Medical Group Orthopedics - Corvallis 3620 Nw Samaritan Drive, Suite 202, Corvallis, OR 97333-1042Family Medicine Physician2012-04-02
Good Samaritan Hospital Corvallis · Samaritan Ucwi Clinic- Corvallis 5234 Philomath Boulevard, Corvallis, OR 97333-1042Family Medicine Physician2012-03-20
Safeway Inc · Safeway Pharmacy #1765 5270 Sw Philomath Blvd, Corvallis, OR 97333-1042Durable Medical Equipment & Medical Supplies2006-07-02
Steven Mark Evans 5270 Sw Philomath Blvd, Corvallis, OR 97333-1042Pharmacist2011-10-21
Sunset Dental 5208 Sw Philomath Blvd, Corvallis, OR 97333-1042General Practice Dentistry2006-03-21
Charlotte P Gardner 5234 Sw Philomath Boulevard, Corvallis, OR 97333-1042Physician Assistant2006-10-20

Providers in the same zip code

Provider NameAddressTaxonomyEnumeration Date
Linda S Lavallee Conniff 216 Sw Madison Av, #9 10, Corvallis, OR 97333Clinical Social Worker2007-07-06
Michael S. Hanson 518 Sw 3rd St., Corvallis, OR 97333Addiction (Substance Use Disorder) Counselor2010-04-28
Pamela M Swafford 4515 Sw Country Club Drive, Corvallis, OR 97333Counselor2006-11-29
Robert R Conniff 216 Sw Madison Ave, 2, Corvallis, OR 97333Clinical Social Worker2007-07-03
Pavan Kumar K Gona 3615 Nw Samaritan Drive, Suite 201, Corvallis, OR 97333Internal Medicine Physician2007-07-18
Adam Johnson 518 Sw 3rd, Corvallis, OR 97333Addiction (Substance Use Disorder) Counselor2017-08-16
Corvallis Physical Therapy Inc 230 Sw 3rd Street Suite 208, Corvallis, OR 97333Physical Therapist2008-04-09
Susan Wilson Rosen 530 Nw 27th St, Corvallis, OR 97333Physician Assistant2007-09-06
Deborah Elizabeth Anderson 5060 Sw Philomath Blvd #336, Corvallis, OR 97333Naturopath2011-09-26
Raeann N Mcspadden · Raeann N Barnes 1650 Sw 45th Pl, Corvallis, OR 97333Behavior Technician2017-06-08
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Dataset Information

This dataset includes over five million health care providers who are assigned National Provider Identifier (NPI) in the National Plan and Provider Enumeration System (NPPES), developed by the Centers for Medicare & Medicaid Services (CMS). Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under Health Insurance Portability and Accountability Act (HIPAA). Each provider is registered with the NPI, full name, status, address, taxonomy, other identifiers, etc.

Subject Transparency and Disclosure
Jurisdiction Federal
Data Provider National Plan and Provider Enumeration System (NPPES), by the Centers for Medicare & Medicaid Services (CMS)
Source download.cms.gov

Dataset Details

The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers and all health plans and health care clearinghouses, who must use the NPIs in the administrative and financial transactions adopted under HIPAA. The NPI is a 10-position, intelligence-free numeric identifier (10-digit number).

All health care providers who are HIPAA-covered entities, whether individuals or organizations, must get an NPI. A HIPAA-covered entity is a health care provider that conducts certain transactions in electronic form, or a health care clearinghouse, or a health plan (including commercial plans, Medicare, and Medicaid).

Centers for Medicare & Medicaid Services (CMS) has developed the National Plan and Provider Enumeration System (NPPES) to assign unique identifiers to health care providers. The National Provider Indentifier (NPI) has been the standard identifier for all HIPAA-covered entities (health care providers) since May 23, 2007. Small health plans were required to obtain and use an NPI by May 23, 2008.

This dataset includes over five million health care providers (individuals and organizations) who are assigned NPI. The provider data elements are disclosed to the public by the Centers for Medicare & Medicaid Services (CMS) under the Freedom of Information Act (FOIA), as listed in the NPPES Data Dissemination Notice (CMS-6060-N). The NPI final rules define the following elements which required to be disclosed as determined by Department of Health & Human Services (HHS): NPI, Entity Type, Provider Name, Credential, Business Mailing Address, Business Location Address, Healthcare Provider Taxonomy Code, Other Provider Identifier, Provider Enumeration Date, NPI Deactivation Date, Provider License Number, Authorized Official Name and Contact Information.