Gustavo Rodriguez, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DR.0053640 Issued in CO

Practice address

101 Erie Pkwy, Ste 201C
Erie, CO 80516

Phone

(303) 415-5816

Fax

(303) 293-0625

NPI assigned

Apr 14, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

University of Texas Medical Branch at Galveston, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Intermountain Medical Group Denver LLCGroup PAC ID 0840513552, 571 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Good Samaritan Medical Center LLC Hospital, Lafayette, CO, CCN 060116

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Intermountain Medical Group Denver, LLC

  • Family Medicine Physician
  • Denver, CO
  • NPI 1083021083
  Medicare reassignment Care Compare group NPD
• Intermountain Medical Group Denver, LLC

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Denver, CO
  • NPI 1083598874
  NPD
• Intermountain Medical Group Denver, LLC

  • Family Medicine Physician
  • Aurora, CO
  • NPI 1275213993
  NPD
• Boulder Community Health

  • Medical Specialty Clinic/Center
  • Boulder, CO
  • NPI 1407685498
  NPD (past)
• Boulder Community Health

  • Multi-Specialty Clinic/Center
  • Boulder, CO
  • NPI 1609822030
  NPD (past)
• Austin Diagnostic Clinic, PA

  • Ambulatory Surgical Clinic/Center
  • Austin, TX
  • NPI 1619923950
  NPD (past)

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

• Good Samaritan Medical Center, LLC

  • General Acute Care Hospital
  • Lafayette, CO
  • NPI 1407845035
  Care Compare affiliation

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

{
    "created_epoch": "1239667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693785600000",
    "number": "1295978740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9049",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803049049",
            "telephone_number": "303-415-5816",
            "fax_number": "303-293-0625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 ERIE PKWY, STE 201C",
            "city": "ERIE",
            "state": "CO",
            "postal_code": "80516",
            "telephone_number": "303-415-5816",
            "fax_number": "303-293-0625"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1401 Medical Parkway, Bldg C, Suite 150",
            "address_purpose": "LOCATION",
            "city": "Cedar Park",
            "state": "TX",
            "postal_code": "78613",
            "country_code": "US",
            "telephone_number": "512-901-4038",
            "fax_number": "512-485-0086",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "GUSTAVO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-14",
        "last_updated": "2023-09-04",
        "certification_date": "2023-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "Q0552",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0053640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Manuela Roa Gonzalez, MSW, SWC
• Aimee Leigh Robb, PT, DPT
• Wanda S Roberts, R.N.
• Ari Robkin
• Jessica Rodenburg
• Sarah Rohr, OD
• Karen I Rojas
• Rebecca Ronald, NP
• Rooted Psychotherapy and Counseling
• Chad Alan Ross

• Family Medicine Physician in Erie, CO
• Providers in Erie, CO by specialty
• Family Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 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.