Individual provider Active NPI

Moses Joel Rodriguez, AGPCNP-BC

  • Adult Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1023641594
Registry record updated Jul 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
309528 Issued in NY
Practice address
1000 10TH Ave Lowr Level
New York, NY 10019-1147
Phone
(212) 523-7164
NPI assigned
Feb 12, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 1175818 TX
Adult Health Nurse Practitioner 363LA2200X 309528 NY Primary

Addresses

Primary practice location

1000 10TH Ave Lowr Level
New York, NY 10019-1147

Mailing address

1000 10TH Ave Lowr Level
New York, NY 10019-1147
Phone (212) 523-7164

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210624002584 NY Practitioner - Nurse Practitioner 5991106155 Reassigns benefits to 1 organization
I20250423003802 TX Practitioner - Nurse Practitioner 5991106155 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
309528NYMDAdult Health Nurse Practitioner
1175818TXMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Feb 20, 2025 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jan 15, 2022 Accepting new patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Feb 20, 2025 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jan 15, 2022 Accepting new patients

Locations

5 E 98th St
Fl 12
New York, NY 10029
Phone (212) 241-8303

1000 10th Ave
Lowr
New York, NY 10019
Phone (212) 523-7165

1470 Madison Ave
New York, NY 10029
Phone (212) 241-0806

425 W 59th St
Fl 8
New York, NY 10019
Phone (212) 492-5500

1000 10th Ave
Ste 1A69
New York, NY 10019
Phone (212) 523-6424

5201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 590-1396

3000 N Interstate 35
Denton, TX 76201
Phone (469) 303-3591

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1581465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751500800000",
    "number": "1023641594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 10TH AVE LOWR LEVEL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191147",
            "telephone_number": "212-523-7164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 10TH AVE LOWR LEVEL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191147",
            "telephone_number": "212-523-7164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "MOSES",
        "middle_name": "JOEL",
        "name_prefix": "Mr.",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-12",
        "last_updated": "2025-07-03",
        "certification_date": "2025-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "1175818",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "309528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.