Individual provider Active NPI

Martin Andres Rodriguez Wong

  • Medical Laboratory Technician
  • Rutland, VT
National Provider Identifier
1235006040
Registry record updated Oct 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Laboratory TechnicianTaxonomy code 246RM2200X
License
226742
Practice address
34 Ronaldo CT
Rutland, VT 05701-4239
Phone
(510) 599-5295
NPI assigned
Oct 17, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Laboratory TechnicianGroup: 193400000X SINGLE SPECIALTY GROUP 246RM2200X 226742 Primary

Addresses

Primary practice location

34 Ronaldo CT
Rutland, VT 05701-4239

Mailing address

34 Ronaldo CT
Rutland, VT 05701-4239
Phone (510) 599-5295

Other names 1

  • Martin Rodriguez Other name

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1760659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760659200000",
    "number": "1235006040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 RONALDO CT",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014239",
            "telephone_number": "510-599-5295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 RONALDO CT",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014239",
            "telephone_number": "510-599-5295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ WONG",
        "first_name": "MARTIN",
        "middle_name": "ANDRES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-10-17",
        "last_updated": "2025-10-17",
        "certification_date": "2025-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246RM2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician, Pathology, Medical Laboratory",
            "state": null,
            "license": "226742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARTIN",
            "last_name": "RODRIGUEZ",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Rutland, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.