Individual provider Active NPI

Javier Rodriguez, APRN, BC, CNS

  • Adult Health Clinical Nurse Specialist
  • Edinburg, TX
National Provider Identifier
1326021874
Registry record updated Nov 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X
License
AP112177 Issued in TX
Practice address
3519 W Alberta Rd
Edinburg, TX 78539-8466
Phone
(956) 240-2394
NPI assigned
Nov 29, 2005
Last updated
Nov 20, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Clinical Nurse Specialist 364SA2200X 601952 TX
Adult Health Clinical Nurse Specialist 364SA2200X AP112177 TX Primary

Addresses

Primary practice location

3519 W Alberta Rd
Edinburg, TX 78539-8466

Mailing address

2701 Kellie Dr
Edinburg, TX 78542-4707
Phone (956) 240-2394

Other identifiers 1

IdentifierTypeStateIssuer
162240902MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20110414000294 TX Practitioner - Certified Clinical Nurse Specialist (CNS) 9830087550 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3519 W Alberta Rd
Edinburg, TX 78539-8466
Phone (956) 240-2394

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist, Master of Science

State licenses

LicenseStateTypeSpecialty
601952TXMDAdult Health Clinical Nurse Specialist
AP112177TXMDAdult Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Wound & Ostomy Care Services of South Texas, Inc CurrentSince Aug 4, 2009 Accepting new patients

Locations

3519 W Alberta Rd
Edinburg, TX 78539
Phone (956) 240-2394

3303 W Alberta Rd
Edinburg, TX 78539
Phone (956) 424-6163

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.

Hospital & facility affiliations 2

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": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637366400000",
    "number": "1326021874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 KELLIE DR",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785424707",
            "telephone_number": "956-240-2394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3519 W ALBERTA RD",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785398466",
            "telephone_number": "956-240-2394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JAVIER",
        "credential": "APRN, BC, CNS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-29",
        "last_updated": "2021-11-20",
        "certification_date": "2021-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "TX",
            "license": "601952",
            "primary": false
        },
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "TX",
            "license": "AP112177",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "162240902",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edinburg, TX

Sources for this page

Verify at the official NPI Registry.