Individual provider Active NPI

Jonathan Louis Rodriguez, PT, DPT

  • Physical Therapist
  • Albuquerque, NM
National Provider Identifier
1215419593
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
4411 San Mateo Blvd NE Ste 11
Albuquerque, NM 87109-2011
Phone
(515) 217-3907
Fax
(505) 348-0063
NPI assigned
Sep 3, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 0160837 NY
Physical Therapist 225100000X 40QA02053300 NJ
Physical Therapist 225100000X NM Primary

Addresses

Primary practice location

4411 San Mateo Blvd NE Ste 11
Albuquerque, NM 87109-2011

Mailing address

2001 Butterfield Rd Ste 1600
Downers Grove, IL 60515-1211

Other practice location 1

178 Lakeview Ave
Clifton, NJ 07011-4071
Phone (973) 998-8828

Other practice location 2

645 Bloomfield Ave
Verona, NJ 07044-1831
Phone (973) 944-2012

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ, NM3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20181120000262 NY Practitioner - Physical Therapist in Private Practice 2961756424 Reassigns benefits to 4 organizations
I20220411000558 NJ Practitioner - Physical Therapist in Private Practice 2961756424 Reassigns benefits to 2 organizations
I20250710002529 NM Practitioner - Physical Therapist in Private Practice 2961756424 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physical Therapy at Dawn LLCGroup PAC ID 0042221889, 29 clinicians

Practice addresses (Care Compare)

4411 San Mateo Blvd NE
Suite E11
Albuquerque, NM 87109-2029
Phone (630) 296-2223

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0160837NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist Current Accepting new patients
Tawil Physical Therapy and Sports Performance, PA Physical Therapist CurrentSince Apr 30, 2023 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince Nov 10, 2021 Accepting new patients
Core Physical Therapy Services PC Physical Therapist CurrentSince Sep 1, 2021 Accepting new patients
New York Luna Care Physical Therapy PLLC Physical Therapist CurrentSince Nov 10, 2021 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince Nov 10, 2021 Accepting new patients
New York Physical and Occupational Therapy Services, PLLC Physical Therapist CurrentSince Nov 12, 2018 Accepting new patients
Cem Physical Therapy & Rehabilitation Physical Therapist CurrentSince Oct 8, 2022 Accepting new patients
Physical Therapy at Dawn, LLC Physical Therapist CurrentSince Jul 7, 2025 Accepting new patients
Rise PT OT Speech Nutrition PLLC Physical Therapist Past Accepting new patients

Locations

2001 Butterfield Rd
Ste 1600
Downers Grove, IL 60515

178 Lakeview Ave
Clifton, NJ 07011
Phone (973) 998-8828

8701 Kennedy Blvd
North Bergen, NJ 07047
Phone (201) 552-9072

645 Bloomfield Ave
Verona, NJ 07044
Phone (973) 944-2012

4411 San Mateo Blvd NE
Ste 11
Albuquerque, NM 87109
Phone (505) 217-3907

6330 Riverside Plaza Ln NW
Albuquerque, NM 87120
Phone (505) 312-7930

2003 Coney Island Ave
Brooklyn, NY 11223
Phone (347) 394-1600

2579 Ocean Ave
Fl 3
Brooklyn, NY 11229
Phone (646) 780-0925

123 Grove Ave
Cedarhurst, NY 11516
Phone (516) 374-4248

576 Broadhollow Rd
Melville, NY 11747

121 Broadhollow Rd
Melville, NY 11747
Phone (631) 354-5600

1 Blue Hill Plz
Ste 1509
Pearl River, NY 10965
Phone (201) 914-0063

2142 Utopia Pkwy
Whitestone, NY 11357
Phone (718) 767-0610

Organizations & group practices 10

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": "1535932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1215419593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 BUTTERFIELD RD STE 1600",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4411 SAN MATEO BLVD NE STE 11",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871092011",
            "telephone_number": "515-217-3907",
            "fax_number": "505-348-0063"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "178 Lakeview Ave",
            "address_purpose": "LOCATION",
            "city": "Clifton",
            "state": "NJ",
            "postal_code": "070114071",
            "country_code": "US",
            "telephone_number": "973-998-8828",
            "fax_number": "973-998-8830",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "645 Bloomfield Ave",
            "address_purpose": "LOCATION",
            "city": "Verona",
            "state": "NJ",
            "postal_code": "070441831",
            "country_code": "US",
            "telephone_number": "973-944-2012",
            "fax_number": "973-944-2014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JONATHAN",
        "middle_name": "LOUIS",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-03",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "0160837",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02053300",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.