Rodrigo Quevedo, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1315309 Issued in TX

Practice address

3100 Olympus Blvd Ste 500
Coppell, TX 75019-5473

Phone

(214) 442-4214

NPI assigned

Feb 25, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, NM2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southwest Sport and Spine Center IncGroup PAC ID 5496656563, 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Southwest Sport and Spine Center Inc

  • Physical Therapist
  • Las Cruces, NM
  • NPI 1164475208

  TX

  Medicare reassignment Care Compare group NPD
• Real View Diagnostics LLC

  • Physical Therapist
  • Canutillo, TX
  • NPI 1336882026
  NPD
• Northwest Center for Sports Medicine & Physical Therapy, Inc.

  • Physical Therapist
  • Gig Harbor, WA
  • NPI 1982755070
  NPD

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

{
    "created_epoch": "1551052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551052800000",
    "number": "1023575214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 WILLOW GLEN DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799222209",
            "telephone_number": "915-422-8252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 OLYMPUS BLVD STE 500",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750195473",
            "telephone_number": "214-442-4214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUEVEDO",
        "first_name": "RODRIGO",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-02-25",
        "last_updated": "2019-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1315309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elise Elaine Pruett, D.D.S.
• Janis Aveyard Pruett, FNP-BC
• Ptac PLLC
• Amanda Pucelli, OTR/L
• Questcare Medical Clinics PLLC
• Quinlan Chiropractic, PLLC
• John Patrick Quinlan, DC
• Lindsay Claire Rabaey
• Ethan Michael Ryan Rafferty, DPT
• Farhan Rafi, M.D.

• Physical Therapist in Coppell, TX
• Providers in Coppell, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.