Individual provider Active NPI

Juan E Rodriguez, PSY.D.

  • Psychologist
  • Brooklyn, NY
National Provider Identifier
1144536244
Registry record updated Aug 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
018745 Issued in NY
Practice address
514 49TH St
Brooklyn, NY 11220-2010
Phone
(718) 437-5204
Fax
(718) 437-5239
NPI assigned
Aug 26, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 018745 NY Primary

Addresses

Primary practice location

514 49TH St
Brooklyn, NY 11220-2010

Mailing address

514 49TH St
Brooklyn, NY 11220-2010
Phone (718) 437-5204

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jrodriguez133010@nyumc.direct-ci.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140815001431 NY Practitioner - Clinical Psychologist 9638396559 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
NYU Langone HospitalsGroup PAC ID 4981515699, 245 clinicians

Practice addresses (Care Compare)

301 E 17TH St
New York, NY 10003-3804
Phone (212) 598-2454

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
NYU Langone Hospitals Current Accepting new patients
NYU Langone Hospitals CurrentSince Jan 15, 2017 Accepting new patients
NYU Langone Hospitals CurrentSince Jan 15, 2017 Accepting new patients
NYU Lutheran Medical Center Past Accepting new patients

Locations

514 49th St
Brooklyn, NY 11220
Phone (718) 431-2600

150 55th St
Brooklyn, NY 11220
Phone (718) 630-7185

150 55th St
Rm 3618
Brooklyn, NY 11220
Phone (718) 630-7477

301 E 17th St
New York, NY 10003
Phone (212) 460-0125

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: jrodriguez133010@nyumc.direct-ci.com

Organizations & group practices 4

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": "1282780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628812800000",
    "number": "1144536244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 49TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112202010",
            "telephone_number": "718-437-5204",
            "fax_number": "718-437-5239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 49TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112202010",
            "telephone_number": "718-437-5204",
            "fax_number": "718-437-5239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JUAN",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-26",
        "last_updated": "2021-08-13",
        "certification_date": "2021-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "018745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jrodriguez133010@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "514 49th St",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112202010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.