Individual provider Active NPI

Edmee Rodriguez, M.D.

  • Internal Medicine Physician
  • Albuquerque, NM
National Provider Identifier
1346260544
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD2004-0764 Issued in NM
Practice address
4105 Montgomery Blvd NE
Albuquerque, NM 87109-1102
Phone
(505) 737-9411
Fax
(505) 884-6845
NPI assigned
Jul 20, 2006
Last updated
Feb 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD2004-0764 NM Primary

Addresses

Primary practice location

4105 Montgomery Blvd NE
Albuquerque, NM 87109-1102

Mailing address

4105 Montgomery Blvd NE
Albuquerque, NM 87109-1102
Phone (505) 737-9411

Other identifiers 1

IdentifierTypeStateIssuer
40908771MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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

Enrollment IDStateProvider typePAC IDDetails
I20050603000364 NM Practitioner - Internal Medicine 5597751339 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Ponce School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4105 Montgomery Blvd NE
Albuquerque, NM 87109-1102
Phone (505) 737-9411

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
James R Tryon M.D., PC Internal Medicine CurrentSince Jul 15, 2022 Accepting new patients

Locations

4105 Montgomery Blvd NE
Albuquerque, NM 87109
Phone (505) 737-9411

4123 Montgomery Blvd NE
Albuquerque, NM 87109
Phone (505) 226-2300

Interoperability endpoints

  • Direct secure messaging: edmeerodriguez@jtryon.ssdirect.aprima.com

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 5

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1346260544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4105 MONTGOMERY BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871091102",
            "telephone_number": "505-737-9411",
            "fax_number": "505-884-6845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4105 MONTGOMERY BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871091102",
            "telephone_number": "505-737-9411",
            "fax_number": "505-884-6845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "EDMEE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "MD2004-0764",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40908771",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.