Individual provider Active NPI

Susana Maria Sixto-Rodriguez, D.O.

  • Family Medicine Physician
  • Miami, FL
National Provider Identifier
1366403859
Registry record updated Nov 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS0007495 Issued in FL
Practice address
1100 SW 57 Ave #101
Miami, FL 33144
Phone
(305) 644-1550
Fax
(305) 269-1068
NPI assigned
Apr 1, 2006
Last updated
Nov 2, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS0007495 FL Primary

Addresses

Primary practice location

1100 SW 57 Ave #101
Miami, FL 33144

Mailing address

1100 SW 57TH Ave
Suite #101
West Miami, FL 33144-5129
Phone (305) 644-1550

Other identifiers 1

IdentifierTypeStateIssuer
260231800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20111017000257 FL Practitioner - Family Practice 0042482077 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Nova Southeastern College of Osteo Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rodriguez and Sixto Medical Associates, P.a.Group PAC ID 8022007665, 2 clinicians

Practice addresses (Care Compare)

1100 SW 57TH Ave
Suite 101
Miami, FL 33144-5129
Phone (305) 644-1550

National Provider Directory

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GJCJBA/Endpoint/GJCJBA

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.

NPI Registry JSON

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

{
    "created_epoch": "1143849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320192000000",
    "number": "1366403859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 SW 57TH AVE",
            "address_2": "SUITE #101",
            "city": "WEST MIAMI",
            "state": "FL",
            "postal_code": "331445129",
            "telephone_number": "305-644-1550",
            "fax_number": "305-269-1068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 SW 57 AVE #101",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33144",
            "telephone_number": "305-644-1550",
            "fax_number": "305-269-1068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIXTO-RODRIGUEZ",
        "first_name": "SUSANA",
        "middle_name": "MARIA",
        "name_prefix": "Mrs.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-01",
        "last_updated": "2011-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS0007495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "260231800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.