Individual provider Active NPI

Rafael H Rodriguez, RT

  • Radiologic Technologist
  • Cedar Hill, TX
National Provider Identifier
1295760932
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiologic TechnologistTaxonomy code 247100000X
License
5810 Issued in TX
Practice address
2627 Wells CT
Cedar Hill, TX 75104-6943
Phone
(972) 523-6815
Fax
(888) 846-7701
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiologic Technologist 247100000X 5810 TX Primary

Addresses

Primary practice location

2627 Wells CT
Cedar Hill, TX 75104-6943

Mailing address

2627 Wells CT
Cedar Hill, TX 75104-6943
Phone (972) 523-6815

Other practice location 1

3821 Ross Ave
Dallas, TX 75204-5245
Phone (972) 523-6815

Other identifiers 1

IdentifierTypeStateIssuer
459898OtherTXBLUE CROSS/ BLUE SHIELD

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5810TXMDRadiologic Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
R.T. Portable X-Ray Inc. Radiologic Technologist PastSince Jul 24, 2022 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1295760932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2627 WELLS CT",
            "city": "CEDAR HILL",
            "state": "TX",
            "postal_code": "751046943",
            "telephone_number": "972-523-6815",
            "fax_number": "888-846-7701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2627 WELLS CT",
            "city": "CEDAR HILL",
            "state": "TX",
            "postal_code": "751046943",
            "telephone_number": "972-523-6815",
            "fax_number": "888-846-7701"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3821 Ross Ave",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752045245",
            "country_code": "US",
            "telephone_number": "972-523-6815",
            "fax_number": "214-515-9302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "RAFAEL",
        "middle_name": "H",
        "name_prefix": "Mr.",
        "credential": "RT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247100000X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist",
            "state": "TX",
            "license": "5810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/ BLUE SHIELD",
            "identifier": "459898",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Hill, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.