Individual provider Active NPI

Marivee Borges Rodriguez, MD

  • Pediatric Critical Care Medicine Physician
  • Austin, TX
National Provider Identifier
1245636315
Registry record updated Oct 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
U5932 Issued in TX
Practice address
4900 Mueller Blvd
Austin, TX 78723-3051
Phone
(512) 324-0091
NPI assigned
Nov 17, 2014
Last updated
Oct 24, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 13583 PR
Pediatric Critical Care Medicine Physician 2080P0203X U5932 TX Primary

Addresses

Primary practice location

4900 Mueller Blvd
Austin, TX 78723-3051

Mailing address

4900 Mueller Blvd
Austin, TX 78723-3051
Phone (512) 324-0091

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210107001873 MS Practitioner - Pediatric MedicinePractitioner - Critical Care (Intensivists) 0547532947 Reassigns benefits to 1 organization
I20231115001379 TX Practitioner - Pediatric MedicinePractitioner - Critical Care (Intensivists) 0547532947 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13583PRMDClinical Social Worker
U5932TXMDPediatric Critical Care Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dell Children's Medical Group CurrentSince Oct 1, 2023 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Jul 1, 2020 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Jul 1, 2020 Accepting new patients
Dell Children's Medical Group Pediatrics CurrentSince Oct 1, 2023 Accepting new patients

Locations

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

2500 N State St
Ste 4200
Jackson, MS 39216

1301 Barbara Jordan Blvd
Ste 200
Austin, TX 78723
Phone (512) 628-1800

4900 Mueller Blvd
Austin, TX 78723
Phone (512) 324-0165

4910 Mueller Blvd
Ste 100
Austin, TX 78723
Phone (206) 543-3093

Interoperability endpoints

  • Direct secure messaging: mborgesrodriguez78107@ummc.direct-ci.com

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": "1416182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698105600000",
    "number": "1245636315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 MUELLER BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787233051",
            "telephone_number": "512-324-0091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 MUELLER BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787233051",
            "telephone_number": "512-324-0091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORGES RODRIGUEZ",
        "first_name": "MARIVEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-17",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PR",
            "license": "13583",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "TX",
            "license": "U5932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.