Individual provider Active NPI

Katy Rodriguez, PA-C

  • Physician Assistant
  • Irving, TX
National Provider Identifier
1174883938
Registry record updated Aug 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA07866 Issued in TX
Practice address
2801 Gateway Dr
Ste 100
Irving, TX 75063-2694
Phone
(844) 388-6541
Fax
(844) 452-8151
NPI assigned
May 25, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA07866 TX Primary

Addresses

Primary practice location

2801 Gateway Dr
Ste 100
Irving, TX 75063-2694

Mailing address

2801 Gateway Dr
Ste 100
Irving, TX 75063-2694
Phone (844) 388-6541

Other identifiers 1

IdentifierTypeStateIssuer
303494401MedicaidTX

Other names 1

  • Katy Nail Former name

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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120820000178 TX Practitioner - Physician Assistant 5890941256 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellness in Sleep PAGroup PAC ID 0749235877, 4 clinicians

Practice addresses (Care Compare)

908 W Terrell Ave N
Fort Worth, TX 76104-3034
Phone (817) 820-0427

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA07866TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Timarron Family Medicine PA PastSince Jan 1, 2020 Accepting new patients
Texas Medical Diagnostic, Inc Past Accepting new patients
Texas Medical Diagnostic, Inc Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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": "1337904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629331200000",
    "number": "1174883938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 GATEWAY DR",
            "address_2": "STE 100",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750632694",
            "telephone_number": "844-388-6541",
            "fax_number": "844-452-8151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 GATEWAY DR",
            "address_2": "STE 100",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750632694",
            "telephone_number": "844-388-6541",
            "fax_number": "844-452-8151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "KATY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-25",
        "last_updated": "2021-08-19",
        "certification_date": "2021-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA07866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "303494401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATY",
            "last_name": "NAIL",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Irving, TX

Sources for this page

Verify at the official NPI Registry.