Jose M Rodriguez, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036-089962 Issued in IL

Practice address

6240 W 55TH St
Chicago, IL 60638-2531

Phone

(773) 284-2200

Fax

(773) 284-5833

NPI assigned

May 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/11903/brand/1/csg/1/fhir/r4
• Direct secure messaging: jose.rodriguez.1@11903.direct.athenahealth.com

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.

• Access Community Health Network

  • Federally Qualified Health Center (FQHC)
  • Des Plaines, IL
  • NPI 1982783692
  Medicare reassignment NPD
• Esperanza Health Centers

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1124187125
  Medicare reassignment NPD
• Access Community Health Network

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1528147824
  NPD
• Access Community Health Network

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1699701383
  NPD
• Esperanza Health Centers

  dba Esperanza Little Village

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1477812030
  NPD
• Esperanza Health Centers

  dba Lakeshore Hotel Shelter

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1659127199
  NPD
• Esperanza Health Centers

  dba Esperanza at Cultivate Collective

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1265114623
  NPD (past)

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343606400000",
    "number": "1164477113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6240 W 55TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606382531",
            "telephone_number": "773-284-2200",
            "fax_number": "773-284-5833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6240 W 55TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606382531",
            "telephone_number": "773-284-2200",
            "fax_number": "773-284-5833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JOSE",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2012-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-089962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036087962",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Rodriguez
• Jessica Rodriguez
• Jessica Rodriguez
• Jorge Rodriguez, MA
• Jose A. Rodriguez, D.D.S.
• Juliani Rodriguez, APRN
• Karylin I Rodriguez, PT, DPT
• Keith Rodriguez, M.D.
• Kelly Rodriguez, LPC
• Kevyn Rodriguez, PTA

• Family Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.