Active NPI
Ellen Rodriguez, FNP
- Family Nurse Practitioner
- New York, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 26NJ15017900
- Practice address
- 30 Broad St
New York, NY 10004-2304 - Phone
- (888) 401-6582
- NPI assigned
- Feb 12, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 26NR20219700 | NJ | |
| Registered Nurse | 163W00000X | 767501 | NY | |
| Family Nurse Practitioner | 363LF0000X | 26NJ15017900 | NJ | Primary |
Addresses
Primary practice location
30 Broad St
New York, NY 10004-2304
Mailing address
38 Townsend CT
Franklin Park, NJ 08823-1520
Phone (862) 324-4242
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26NR20219700 | NJ | MD | Registered Nurse |
| 767501 | NY | MD | Registered Nurse |
| 26NJ15017900 | NJ | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Live Urgent Care LLC | Current | Accepting new patients | |
| Signify Health Medical Associates of New Jersey, LLC | Current | Accepting new patients |
Locations
363 W Browning Rd
Unit A
Bellmawr, NJ 08031
Phone (856) 333-3616
323 State St
Perth Amboy, NJ 08861
Phone (732) 484-4778
116 Village Blvd
Ste 200
Princeton, NJ 08540
Phone (609) 285-3094
85 Old Stage Rd
Spotswood, NJ 08884
Phone (732) 838-4940
4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037
Organizations & group practices 2
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.
-
- Family Medicine Physician
- Bellmawr, NJ
- NPI 1407439870
-
- General Practice Physician
- Princeton, NJ
- NPI 1174187728
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710288000000",
"number": "1225892136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "38 TOWNSEND CT",
"city": "FRANKLIN PARK",
"state": "NJ",
"postal_code": "088231520",
"telephone_number": "862-324-4242"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 BROAD ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100042304",
"telephone_number": "888-401-6582"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "ELLEN",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-02-12",
"last_updated": "2024-03-13",
"certification_date": "2024-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NJ",
"license": "26NR20219700",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "767501",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NJ",
"license": "26NJ15017900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.