Active NPI
Raul Rodriguez, FNP
- Family Nurse Practitioner
- Minnetonka, MN
National Provider Identifier
1013261379
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 737513
- Practice address
- 9900 Bren Rd E
Minnetonka, MN 55343-9664 - Phone
- (915) 218-8568
- NPI assigned
- Nov 7, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 737513 | TX | Primary |
Addresses
Primary practice location
9900 Bren Rd E
Minnetonka, MN 55343-9664
Mailing address
12487 Tierra Encino Dr
El Paso, TX 79938-4524
Phone (469) 352-4746
Other practice location 1
7420 Remcon Cir
Bldg. A
El Paso, TX 79912-3529
Phone (915) 532-8823
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 737513 | Other | TX | RN 737513 |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ingenios Health Co. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Frisco, TX
- NPI 1134426919
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1352246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601251200000",
"number": "1013261379",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12487 TIERRA ENCINO DR",
"city": "EL PASO",
"state": "TX",
"postal_code": "799384524",
"telephone_number": "469-352-4746"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9900 BREN RD E",
"city": "MINNETONKA",
"state": "MN",
"postal_code": "553439664",
"telephone_number": "915-218-8568"
}
],
"practiceLocations": [
{
"address_1": "7420 Remcon Cir",
"address_2": "Bldg. A",
"address_purpose": "LOCATION",
"city": "El Paso",
"state": "TX",
"postal_code": "799123529",
"country_code": "US",
"telephone_number": "915-532-8823",
"fax_number": "915-225-2015",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "RAUL",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-11-07",
"last_updated": "2020-09-28",
"certification_date": "2020-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TX",
"license": "737513",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RN 737513",
"identifier": "737513",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Minnetonka, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.