Individual provider Active NPI

Gabriel Fondeur Rodriguez, NP

  • Family Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1205797107
Registry record updated Apr 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
358413 Issued in NY
Practice address
2676 Grand Concourse # a
Bronx, NY 10458-4914
Phone
(718) 708-4040
Fax
(718) 708-6040
NPI assigned
Nov 20, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2026

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 358413 NY Primary

Addresses

Primary practice location

2676 Grand Concourse # a
Bronx, NY 10458-4914

Mailing address

2676 Grand Concourse # a
Bronx, NY 10458-4914
Phone (718) 708-4040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
358413NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Audubon Primary Care Medicine PLLC CurrentSince Nov 24, 2025 Accepting new patients

Locations

325 Audubon Ave
New York, NY 10033
Phone (718) 664-7679

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EACGCA/Endpoint/EACGCA

Organizations & group practices 1

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": "1763596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775692800000",
    "number": "1205797107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2676 GRAND CONCOURSE # A",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104584914",
            "telephone_number": "718-708-4040",
            "fax_number": "718-708-6040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2676 GRAND CONCOURSE # A",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104584914",
            "telephone_number": "718-708-4040",
            "fax_number": "718-708-6040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONDEUR RODRIGUEZ",
        "first_name": "GABRIEL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-11-20",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "358413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.