Active NPI
Joelle Rodriguez, O.D.
- Optometrist
- Warwick, NY
National Provider Identifier
1255644803
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 007611
- Practice address
- 36 Ronald Reagan Blvd.
Warwick, NY 10990 - Phone
- (845) 986-5367
- NPI assigned
- Jul 23, 2010
- Last updated
- Aug 26, 2010
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 007611 | NY | Primary |
Addresses
Primary practice location
36 Ronald Reagan Blvd.
Warwick, NY 10990
Mailing address
36 Ronald Reagan Blvd.
Warwick, NY 10990
Phone (845) 986-5367
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007611 | NY | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Luxury Optical Holdings Co | Past | Accepting new patients |
Organizations & group practices 1
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": "1279843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1282780800000",
"number": "1255644803",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "36 RONALD REAGAN BLVD.",
"city": "WARWICK",
"state": "NY",
"postal_code": "10990",
"telephone_number": "845-986-5367"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "36 RONALD REAGAN BLVD.",
"city": "WARWICK",
"state": "NY",
"postal_code": "10990",
"telephone_number": "845-986-5367"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "JOELLE",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-07-23",
"last_updated": "2010-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NY",
"license": "007611",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Warwick, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.