NPIMap

Individual provider Active NPI

Javier Enrique Rodriguez

  • Emergency Medicine Physician
  • Bronx, NY
National Provider Identifier
1275067803
Registry record updated May 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
25MA11263800 Issued in NJ
Practice address
234 E 149TH St
Bronx, NY 10451-5504
Phone
(718) 579-6011
NPI assigned
Apr 20, 2017
Last updated
May 5, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Emergency Medicine Physician 207P00000X 25MA11263800 NJ Primary

Addresses

Primary practice location

234 E 149TH St
Bronx, NY 10451-5504

Mailing address

100 State St Apt 205
Hackensack, NJ 07601-5472

Other names 1

  • Javier Enrique Rodriguez de Jesus Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211207001568 NJ Practitioner - Emergency Medicine 0840680872 Reassigns benefits to 2 organizations
I20220406002011 NY Practitioner - Emergency Medicine 0840680872 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Park Hill Emergency Physician ServicesGroup PAC ID 5395057020, 15 clinicians
Malina Medical Services PCGroup PAC ID 3779943600, 33 clinicians
MGM Ketamine Services LLCGroup PAC ID 5395128482, 12 clinicians

Practice addresses (Care Compare)

127 S Broadway
Yonkers, NY 10701-4006
Phone (914) 378-7000

6 E 39TH St
Suite 600
New York, NY 10016-0123
Phone (201) 483-3760

690 Kinderkamack Rd
Suite 103
Oradell, NJ 07649-1524
Phone (201) 483-3760

718 Teaneck Rd
Teaneck, NJ 07666-4245
Phone (201) 833-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA11263800NJMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Park Hill Emergency Physician Services Emergency Medicine CurrentSince Feb 13, 2025 Accepting new patients
Emergency Physician Services of New Jersey,Professional Association Emergency Medicine CurrentSince Dec 1, 2021 Accepting new patients

Locations

175 Madison Ave
Mount Holly, NJ 08060
Phone (609) 261-1660

718 Teaneck Rd
Teaneck, NJ 07666
Phone (201) 833-3232

66 W Gilbert St
Tinton Falls, NJ 07701
Phone (732) 212-0051

127 S Broadway
Yonkers, NY 10701
Phone (914) 378-7342

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 5

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1492646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651708800000",
    "number": "1275067803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 STATE ST APT 205",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076015472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 E 149TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104515504",
            "telephone_number": "718-579-6011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JAVIER",
        "middle_name": "ENRIQUE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-20",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MA11263800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAVIER",
            "last_name": "RODRIGUEZ DE JESUS",
            "middle_name": "ENRIQUE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.