Individual provider Active NPI

Carlos Jose Rodriguez, DO

  • Surgery Physician
  • Fort Worth, TX
National Provider Identifier
1215991054
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
R7867 Issued in TX
Practice address
800 5TH Ave Ste 410
Fort Worth, TX 76104-7311
Phone
(817) 250-7030
NPI assigned
Apr 17, 2006
Last updated
Jun 10, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X R7867 TX Primary
Surgical Critical Care Physician 2086S0102X R7867 TX

Addresses

Primary practice location

800 5TH Ave Ste 410
Fort Worth, TX 76104-7311

Mailing address

800 5TH Ave Ste 410
Fort Worth, TX 76104-7311
Phone (817) 250-7030

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180813002815 TX Practitioner - General SurgeryPractitioner - Critical Care (Intensivists) 1951493444 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Critical Care (Intensivists)
Education
New York College of Osteo Medicine of New York Institute of Technology, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Health Physicians GroupGroup PAC ID 4385535954, 1,364 clinicians

Practice addresses (Care Compare)

800 5TH Ave
Suite 410
Fort Worth, TX 76104-7311
Phone (817) 250-7230

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)15
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
R7867TXMDSurgical Critical Care Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Physicians Group Current Accepting new patients
Texas Health Physicians Group CurrentSince Dec 20, 2021 Accepting new patients
Texas Health Physicians Group CurrentSince Dec 20, 2021 Accepting new patients
Acclaim Physician Group, Inc CurrentSince Sep 1, 2018 Accepting new patients
Texas Health Harris Methodist Hospital Fort Worth Past Accepting new patients

Locations

1600 Hospital Pkwy
Bedford, TX 76022
Phone (817) 355-7803

1325 Pennsylvania Ave
Ste 690
Fort Worth, TX 76104
Phone (817) 761-7740

1350 S Main St
Fl 1
Fort Worth, TX 76104
Phone (817) 702-3701

800 5th Ave
Ste 410
Fort Worth, TX 76104
Phone (817) 250-7030

1412 May St
Ft Worth, TX 76104
Phone (817) 625-8818

1500 S Main St
Ft Worth, TX 76104
Phone (817) 921-3431

Interoperability endpoints

  • Direct secure messaging: crodriguez2016433@direct.texashealth.org
  • FHIR API: https://epproxy.texashealth.org/FHIR/api/FHIR/DSTU2/

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1215991054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 5TH AVE STE 410",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761047311",
            "telephone_number": "817-250-7030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 5TH AVE STE 410",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761047311",
            "telephone_number": "817-250-7030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "CARLOS",
        "middle_name": "JOSE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "R7867",
            "primary": true
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "TX",
            "license": "R7867",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.