Individual provider Active NPI

Mauro Daniel Rodriguez

  • Pediatrics Physician
  • Kansas City, MO
National Provider Identifier
1336645472
Registry record updated Nov 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2022019188 Issued in MO
Practice address
2401 Gillham Rd
Kansas City, MO 64108-4619
Phone
(816) 234-3000
Fax
(816) 302-9939
NPI assigned
Apr 5, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X S5054 TX
Pediatrics Physician 208000000X 2022019188 MO Primary

Addresses

Primary practice location

2401 Gillham Rd
Kansas City, MO 64108-4619

Mailing address

2401 Gillham Rd
Kansas City, MO 64108-4619
Phone (816) 234-3000

Other practice location 1

6431 Fannin St
Houston, TX 77030-1501
Phone (713) 500-5151

Other practice location 2

6431 Fannin St
Houston, TX 77030-1501
Phone (713) 500-5151

Other identifiers 1

IdentifierTypeStateIssuer
2022019188OtherMOMO MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, MO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210511000844 TX Practitioner - Pediatric Medicine 3476962101 Reassigns benefits to 2 organizations
I20231206000679 MO Practitioner - Pediatric Medicine 3476962101 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ut PhysiciansGroup PAC ID 8426960360, 1,744 clinicians

Practice addresses (Care Compare)

23900 Katy Fwy
Katy, TX 77494-1323
Phone (281) 644-7000

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Children's Mercy Hospital Pediatrics CurrentSince Dec 1, 2023 Accepting new patients
Memorial Hermann Hospital Based Physician Group CurrentSince Oct 6, 2025 Accepting new patients
The Children's Mercy Hospital CurrentSince Dec 1, 2023 Accepting new patients

Locations

2401 Gillham Rd
Kansas City, MO 64108
Phone (816) 234-3380

921 Gessner Rd
Houston, TX 77024
Phone (713) 242-3439

22430 Grand Corner Dr
#C1100
Katy, TX 77494

23900 Katy Fwy
Katy, TX 77494
Phone (281) 644-7000

2555 Gulf Fwy S
#C1100
League City, TX 77573

16100 South Fwy
Pearland, TX 77584
Phone (713) 413-5000

9250 Pinecroft Dr
#C
Shenandoah, TX 77380

9250 Pinecroft Dr
Shenandoah, TX 77380
Phone (281) 364-2300

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.

NPI Registry JSON

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

{
    "created_epoch": "1522886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700092800000",
    "number": "1336645472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 GILLHAM RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641084619",
            "telephone_number": "816-234-3000",
            "fax_number": "816-302-9939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 GILLHAM RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641084619",
            "telephone_number": "816-234-3000",
            "fax_number": "816-302-9939"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6431 Fannin St",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770301501",
            "country_code": "US",
            "telephone_number": "713-500-5151",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6431 Fannin St",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770301501",
            "country_code": "US",
            "telephone_number": "713-500-5151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "MAURO",
        "middle_name": "DANIEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-05",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "S5054",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2022019188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MO MEDICAL LICENSE",
            "identifier": "2022019188",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.