Individual provider Active NPI

Amalia Rodriguez

  • Physician Assistant
  • Ocoee, FL
National Provider Identifier
1275044968
Registry record updated Dec 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9110748 Issued in FL
Practice address
10000 W Colonial Dr Ste 187
Ocoee, FL 34761-3438
Phone
(407) 578-6610
NPI assigned
Oct 20, 2017
Last updated
Dec 15, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA059523 PA
Physician Assistant 363A00000X OA004343 PA
Physician Assistant 363A00000X PA9110748 FL Primary

Addresses

Primary practice location

10000 W Colonial Dr Ste 187
Ocoee, FL 34761-3438

Mailing address

10000 W Colonial Dr Ste 187
Ocoee, FL 34761-3438

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20191021000754 FL Practitioner - Physician Assistant 3375874555 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
94.2 of 100Reported as group
Quality
78.64
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA059523PAMDPhysician Assistant
OA004343PAMDPhysician Assistant

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": "1508457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513296000000",
    "number": "1275044968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10000 W COLONIAL DR STE 187",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347613438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 W COLONIAL DR STE 187",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347613438",
            "telephone_number": "407-578-6610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "AMALIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-20",
        "last_updated": "2017-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA059523",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA004343",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9110748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocoee, FL

Sources for this page

Verify at the official NPI Registry.