Individual provider Active NPI

Rodrigue Tertus, P.A.

  • Physician Assistant
  • Boynton Beach, FL
National Provider Identifier
1285840264
Registry record updated Feb 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
10752 Emilia Isles Ter
Boynton Beach, FL 33473-4965
Phone
(561) 739-8665
NPI assigned
May 15, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Care Registered Respiratory Therapist 2279G1100X 43ZA00065700 NJ
Surgical Physician Assistant 363AS0400X 25MP00078700 NJ
Surgical Physician Assistant 363AS0400X PA9107169 FL
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

10752 Emilia Isles Ter
Boynton Beach, FL 33473-4965

Mailing address

10752 Emilia Isles Ter
Boynton Beach, FL 33473-4965
Phone (973) 763-9136

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
I20151229002444 FL Practitioner - Physician Assistant 4789755331 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

800 Meadows Rd
Boca Raton, FL 33486-2304
Phone (561) 395-7100

Hospital & facility affiliations

  • Delray Medical Center Hospital, Delray Beach, FL, CCN 100258

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
43ZA00065700NJMDGeneral Care Registered Respiratory Therapist
PA9107169FLMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Central Avenue Professional Services, PC Past Accepting new patients
Saint Michaels Physician Services PC PastSince Feb 23, 2013 Accepting new patients

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675641600000",
    "number": "1285840264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10752 EMILIA ISLES TER",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334734965",
            "telephone_number": "973-763-9136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10752 EMILIA ISLES TER",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334734965",
            "telephone_number": "561-739-8665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERTUS",
        "first_name": "RODRIGUE",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2279G1100X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered, General Care",
            "state": "NJ",
            "license": "43ZA00065700",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00078700",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9107169",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

Verify at the official NPI Registry.