Individual provider Active NPI

Jorge Rodriguez, O.D.

  • Optometrist
  • San Antonio, TX
National Provider Identifier
1073952800
Registry record updated Oct 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8197T Issued in TX
Practice address
9157 Huebner Rd
San Antonio, TX 78240-1502
Phone
(210) 697-2001
Fax
(210) 558-7679
NPI assigned
Jun 14, 2013
Last updated
Oct 20, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 8197T TX Primary

Addresses

Primary practice location

9157 Huebner Rd
San Antonio, TX 78240-1502

Mailing address

9157 Huebner Rd
San Antonio, TX 78240-1502
Phone (210) 697-2001

Other identifiers 1

IdentifierTypeStateIssuer
8197TOtherTXMEDICAL LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131014000144 TX Practitioner - Optometry 2163656869 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Center Ophthalmology AssociatesGroup PAC ID 1153390398, 12 clinicians

Practice addresses (Care Compare)

608 N Bedell Ave
Suite a
Del Rio, TX 78840-4109
Phone (210) 697-2020

9157 Huebner Rd
San Antonio, TX 78240-1502
Phone (210) 697-2020

Merit-based Incentive Payment System (MIPS)

Final score
92.97 of 100Reported as group
Quality
98.67
Improvement activities
40
Cost
78.34

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8197TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Center Ophthalmology Associates CurrentSince Jul 11, 2013 Accepting new patients
Medical Center Ophthalmology Associates Optometrist CurrentSince Jul 11, 2013 Accepting new patients

Locations

134 Menger Spgs
Ste 1130
Boerne, TX 78006
Phone (830) 816-9500

608 N Bedell Ave
#A
Del Rio, TX 78840
Phone (830) 775-7271

109 Gallery Cir
Ste 139
San Antonio, TX 78258

11900 Crownpoint
Ste 140
San Antonio, TX 78233

9157 Huebner Rd
San Antonio, TX 78240
Phone (210) 697-2001

9730 Westover Hills Blvd
Ste 110
San Antonio, TX 78251

Organizations & group practices 2

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": "1371168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1073952800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9157 HUEBNER RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782401502",
            "telephone_number": "210-697-2001",
            "fax_number": "210-558-7679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9157 HUEBNER RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782401502",
            "telephone_number": "210-697-2001",
            "fax_number": "210-558-7679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JORGE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-14",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8197T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "8197T",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.