Rodolfo Jimenez, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2763 Issued in AZ

Practice address

1260 S Campbell Rd
Green Valley, AZ 85614

Phone

(520) 625-3691

Fax

(520) 625-2894

NPI assigned

May 26, 2005

Sex

Male

Sole proprietor

No

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.

• Suvida Healthcare Clinical Services LLC

  • Multi-Specialty Clinic/Center
  • Tucson, AZ
  • NPI 1972286003

  AZ, Family Medicine

  Medicare reassignment Care Compare group NPD
• United Community Health Center - Maria Auxiliadora, Inc.

  • Federally Qualified Health Center (FQHC)
  • Green Valley, AZ
  • NPI 1093766867
  NPD
• United Community Health Center-Maria Auxiliadora, Inc.

  • Federally Qualified Health Center (FQHC)
  • Amado, AZ
  • NPI 1174705180
  NPD (past)
• United Community Health Center-Maria Auxiliadora, Inc.

  • Federally Qualified Health Center (FQHC)
  • Green Valley, AZ
  • NPI 1548210461
  NPD (past)
• United Community Health Center-Maria Auxiliadora, Inc.

  • Federally Qualified Health Center (FQHC)
  • Tucson, AZ
  • NPI 1760663389
  NPD (past)
• United Community Health Center-Maria Auxiliadora, Inc.

  • Federally Qualified Health Center (FQHC)
  • Tucson, AZ
  • NPI 1881875409
  NPD (past)

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• United Community Health Center - Maria Auxiliadora, Inc.

  • Federally Qualified Health Center (FQHC)
  • Green Valley, AZ
  • NPI 1093766867

  Corporate Officer, W-2 Managing Employee

  CMS ownership
• United Community Health Center-Maria Auxiliadora, Inc.

  • Federally Qualified Health Center (FQHC)
  • Amado, AZ
  • NPI 1063732675

  Corporate Officer, W-2 Managing Employee

  CMS ownership
• United Community Health Center-Maria Auxiliadora, Inc.

  • Federally Qualified Health Center (FQHC)
  • Green Valley, AZ
  • NPI 1972968360

  Corporate Officer, Operational/Managerial Control, W-2 Managing Employee

  CMS ownership

Specialty

Family Practice

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Suvida Healthcare Clinical Services LLC 8 clinicians

Practice addresses (Care Compare)

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rodolfo.jimenez@509680731226116.direct.elationemr.com

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 31, 2020.

{
    "created_epoch": "1117065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580428800000",
    "number": "1013910751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1260 S CAMPBELL AVE",
            "address_2": "BLDG. 2",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "856140503",
            "telephone_number": "520-407-5606",
            "fax_number": "520-625-8504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 S CAMPBELL RD",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "85614",
            "telephone_number": "520-625-3691",
            "fax_number": "520-625-2894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "RODOLFO",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-26",
        "last_updated": "2020-01-31",
        "certification_date": "2020-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "2763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "113799",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139081",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Green Valley, AZ
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.