KATHLEEN IRENE RODENBURG (PA-C) – Surgical Physician Assistant, NPI 1003286360
Surgical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
10,564 PHYSICIAN ASSISTANT in CA
Provider Addresses for KATHLEEN IRENE RODENBURG (PA-C)
18 BON AIR RD
LARKSPUR, CA 949391123
Phone: (415) 927-5300
Fax: (415) 927-6860
Type: Mailing
14795 SW Murray Scholls Dr Ste 109
Beaverton, OR 970079230
Phone: (503) 906-4301
Fax: (503) 906-6613
Type: Location
11782 SW BARNES RD STE 300
PORTLAND, OR 972255933
Phone: (503) 214-5520
Fax: (503) 906-6613
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $124.
Total Amount is formed as General ($124) + Research ($0) + Ownership ($0) = $124.
Last reported payment date: 2024-07-25 • Largest payer in this snapshot: Medical Device Business Services, Inc. ($52).
Total Amount
$124
General + Research + Ownership
Payments
4
Total payment records
General Amount
$124
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-07-25
Latest reported date
Top Companies
Largest payers in this snapshot
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2021-12-13
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20151113002517 | I | Physician Assistant | CA | TBD |
| I20211213002015 | I | Physician Assistant | OR | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 149 | 31 | $0 |
| 73030 | X-ray of shoulder, minimum of 2 views | 102 | 61 | $0 |
| 20610 | Aspiration and/or injection of fluid from large joint | 98 | 75 | $0 |
| J7324 | Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose | 85 | 45 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 73 | 54 | $0 |
Insurance plans in this area (ZIP 94939)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | CA | 27447 | Repair of knee joint | 17 | 17 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | AL | |
| Physical Therapist In Private Practice | WA | |
| Physical Therapist In Private Practice | OR | |
| Occupational Therapist In Private Practice | OR | |
| Physician Assistant | OR | |
| Occupational Therapist In Private Practice | OR | |
| Physician Assistant | MA | |
| Physical Medicine And Rehabilitation | OR | |
| Orthopedic Surgery | OR | |
| Hand Surgery, Orthopedic Surgery | OR |
Reviews
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