Individual provider Active NPI

Christian Bo Rodriguez

  • Emergency Medicine Physician
  • Manhasset, NY
National Provider Identifier
1225665003
Registry record updated Mar 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME160727 Issued in FL
Practice address
300 Community Drive
Emergency Medicine- Resident Division
Manhasset, NY 11030-3816
Phone
(929) 359-2653
NPI assigned
Mar 24, 2020
Last updated
Mar 15, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X ME160727 FL Primary

Addresses

Primary practice location

300 Community Drive
Emergency Medicine- Resident Division
Manhasset, NY 11030-3816

Mailing address

300 Community Drive
Department of Em, Admin Suice C, Attn: Elnora Brevard
Manhasset, NY 11030-3816
Phone (929) 359-2653

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20240131005011 FL Practitioner - Emergency Medicine 6002269511 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME160727FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Services of FL, LLC Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients
Westchester General Hospital, Inc. CurrentSince Feb 17, 2024 Accepting new patients
Synergy Medical Collective, PA Emergency Medicine CurrentSince Feb 1, 2024 Accepting new patients
Westchester General Hospital, Inc. CurrentSince Feb 17, 2024 Accepting new patients

Locations

322 SW Pine Island Rd
Cape Coral, FL 33991
Phone (941) 249-6858

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

2500 SW 75th Ave
Miami, FL 33155
Phone (305) 431-0577

105 Tamiami Trl
Fl Tamiami
Port Charlotte, FL 33953

14000 Fivay Rd
Port Richey, FL 34667
Phone (727) 819-2929

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1585008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1225665003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 COMMUNITY DRIVE",
            "address_2": "DEPARTMENT OF EM, ADMIN SUICE C, ATTN: ELNORA BREVARD",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303816",
            "telephone_number": "929-359-2653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 COMMUNITY DRIVE",
            "address_2": "EMERGENCY MEDICINE- RESIDENT DIVISION",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303816",
            "telephone_number": "929-359-2653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "CHRISTIAN",
        "middle_name": "BO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-24",
        "last_updated": "2023-03-15",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME160727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhasset, NY

Sources for this page

Verify at the official NPI Registry.