Individual provider Active NPI

Rodolfo Jimenez, D.O.

  • Family Medicine Physician
  • Green Valley, AZ
National Provider Identifier
1013910751
Registry record updated Jan 31, 2020
On this page

Key facts

NPPES NPI Registry
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
Last updated
Jan 31, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2763 AZ Primary

Addresses

Primary practice location

1260 S Campbell Rd
Green Valley, AZ 85614

Mailing address

1260 S Campbell Ave
BLDG. 2
Green Valley, AZ 85614-0503
Phone (520) 407-5606

Medicare participation

Medicare enrollment files
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050504000666 AZ Practitioner - Family Practice 1759321284 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Suvida Healthcare Clinical Services LLCGroup PAC ID 3971967746, 8 clinicians

Practice addresses (Care Compare)

1227 W Saint Marys Rd
Tucson, AZ 85745-3115
Phone (520) 613-2967

3728 S 16TH Ave
Tucson, AZ 85713-6080
Phone (520) 613-2967

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
United Community Health Center - Maria Auxiliadora, Inc. Current Accepting new patients
Suvida Healthcare Clinical Services LLC Family Medicine CurrentSince Aug 29, 2023 Accepting new patients
United Community Health Center-Maria Auxiliadora, Inc. Past Accepting new patients
United Community Health Center-Maria Auxiliadora, Inc. Past Accepting new patients
United Community Health Center-Maria Auxiliadora, Inc. PastSince Jun 23, 2025 Accepting new patients
United Community Health Center-Maria Auxiliadora, Inc. Past Accepting new patients

Locations

1260 S Campbell Ave
Green Valley, AZ 85614
Phone (520) 407-5600

1260 S Campbell Ave
Bldg 1
Green Valley, AZ 85614
Phone (520) 407-5400

1260 S Campbell Ave
Bldg 2
Green Valley, AZ 85614
Phone (520) 407-5400

4475 S I 19 Frontage Rd
Ste 139
Green Valley, AZ 85614
Phone (520) 407-5600

1227 W Saint Marys Rd
Tucson, AZ 85745
Phone (520) 613-2967

225 E Valencia Rd
Ste 135
Tucson, AZ 85706
Phone (520) 290-8787

3728 S 16th Ave
Tucson, AZ 85713
Phone (520) 613-2967

211 E 7th St
Ste 700
Austin, TX 78701
Phone (346) 639-3438

Interoperability endpoints

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

Ownership & related parties

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Continental School Wellness CenterGreen Valley, AZ, CCN 031802 Federally qualified health center Corporate Officer
W-2 Managing Employee
Jan 2, 2007
Feb 19, 2013
United Community Health Center-Maria Auxiliadora, IncAmado, AZ, CCN 031901 Federally qualified health center Corporate Officer
W-2 Managing Employee
Sep 19, 2011
Sep 19, 2011
United Community Health CenterGreen Valley, AZ, CCN 031936 Federally qualified health center Corporate Officer
W-2 Managing Employee
Operational/Managerial Control
Jan 28, 2015
Jan 28, 2015
Jan 28, 2015

Owned or controlled facilities with NPI records 3

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

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "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": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Valley, AZ

Sources for this page

Verify at the official NPI Registry.