Jackeline Victoria Rodriguez, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

26NJ14860800 Issued in NJ

Practice address

525 Union Blvd
Totowa, NJ 07512-2442

Phone

(862) 229-0559

NPI assigned

May 24, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Signify Health Medical Associates of New Jersey, LLC

  • General Practice Physician
  • Princeton, NJ
  • NPI 1174187728
  Medicare reassignment

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

{
    "created_epoch": "1684886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1265124515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 WAYNE AVE",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075021912",
            "telephone_number": "551-208-9202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 UNION BLVD",
            "city": "TOTOWA",
            "state": "NJ",
            "postal_code": "075122442",
            "telephone_number": "862-229-0559"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "221 Wayne Ave",
            "address_purpose": "LOCATION",
            "city": "Paterson",
            "state": "NJ",
            "postal_code": "075021912",
            "country_code": "US",
            "telephone_number": "551-208-9202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JACKELINE",
        "middle_name": "VICTORIA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-24",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ14860800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Toni Anne Raymond, DMD
• Rejuvenation Center for Mind and Body
• Marlene E Reyes, DOULA
• Melanie Elisie Reyes, AGACNP
• Kristin Ribe
• Roland a Ghanem,MD LLC
• Jessica Lycette Romero-Loaiza, MSN, RN, WHNP-BC
• Matthew Ian Rosario, LPC
• Gabriella C Rose
• John Peter Rossi, RD

• Family Nurse Practitioner in Totowa, NJ
• Providers in Totowa, NJ by specialty
• Family Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.