NPIMap

Individual provider Active NPI

Angela Rodriguez, FNP

  • Family Nurse Practitioner
  • El Paso, TX
National Provider Identifier
1083042410
Registry record updated Nov 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP124679 Issued in TX
Practice address
4801 Alberta Ave
El Paso, TX 79905
Phone
(915) 215-5300
Fax
(915) 215-8606
NPI assigned
Oct 22, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP124679 TX Primary

Addresses

Primary practice location

4801 Alberta Ave
El Paso, TX 79905

Mailing address

440 Raynolds St # 51015
El Paso, TX 79905-1613
Phone (915) 215-4480

Other practice location 1

5160 El Paso Dr
El Paso, TX 79905-2819
Phone (915) 774-2550

Other practice location 2

5160 El Paso Dr
El Paso, TX 79905-2819
Phone (915) 774-2550

Other identifiers 2

IdentifierTypeStateIssuer
332680304MedicaidTX
341127YLPSOtherTXWELLMED PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140423000869 TX Practitioner - Nurse Practitioner 2264664457 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4801 Alberta Ave
El Paso, TX 79905-2707
Phone (915) 215-5400

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center El Paso Current Accepting new patients
El Paso County Hospital District CurrentSince Aug 1, 2015 Accepting new patients
Texas Tech University Health Sciences Center El Paso CurrentSince Nov 4, 2019 Accepting new patients
Texas Tech University Health Sciences Center El Paso CurrentSince Nov 4, 2019 Accepting new patients
El Paso County Hospital District CurrentSince Aug 1, 2015 Accepting new patients

Locations

4801 Alberta Ave
El Paso, TX 79905
Phone (915) 215-5200

4815 Alameda Ave
El Paso, TX 79905
Phone (915) 215-6000

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1382400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572998400000",
    "number": "1083042410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 RAYNOLDS ST # 51015",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799051613",
            "telephone_number": "915-215-4480",
            "fax_number": "915-215-5386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 ALBERTA AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "79905",
            "telephone_number": "915-215-5300",
            "fax_number": "915-215-8606"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5160 El Paso Dr",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799052819",
            "country_code": "US",
            "telephone_number": "915-774-2550",
            "fax_number": "915-774-2551",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5160 El Paso Dr",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799052819",
            "country_code": "US",
            "telephone_number": "915-774-2550",
            "fax_number": "915-774-2551",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "ANGELA",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-22",
        "last_updated": "2019-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP124679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "332680304",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMED PTAN",
            "identifier": "341127YLPS",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.