Individual provider Active NPI

Elizabeth Rodriguez, FNP

  • Family Nurse Practitioner
  • East Hartford, CT
National Provider Identifier
1386405421
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
12.012763 Issued in CT
Practice address
94 Connecticut Blvd
East Hartford, CT 06108-3013
Phone
(860) 416-6664
NPI assigned
Jan 16, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 12.012763 CT Primary

Addresses

Primary practice location

94 Connecticut Blvd
East Hartford, CT 06108-3013

Mailing address

94 Connecticut Blvd
East Hartford, CT 06108-3013
Phone (860) 416-6664

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20240430000095 CT Practitioner - Nurse Practitioner 6800236456 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12.012763CTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Charter Oak Health Center, Inc. CurrentSince Jul 14, 2025 Accepting new patients
First Choice Health Centers, Inc. CurrentSince Feb 25, 2024 Accepting new patients
First Choice Health Centers, Inc. CurrentSince Feb 25, 2024 Accepting new patients
Charter Oak Health Center, Inc. CurrentSince Jul 14, 2025 Accepting new patients

Locations

809 Main St
East Hartford, CT 06108
Phone (203) 788-1479

478 Burnside Ave
East Hartford, CT 06108
Phone (860) 289-7161

21 Grand St
Hartford, CT 06106

94 Connecticut Blvd
Hartford, CT 06108
Phone (860) 610-6191

150 N Main St
Manchester, CT 06042
Phone (860) 533-3434

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": "1705363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1386405421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94 CONNECTICUT BLVD",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061083013",
            "telephone_number": "860-416-6664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 CONNECTICUT BLVD",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061083013",
            "telephone_number": "860-416-6664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "ELIZABETH",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-16",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "12.012763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Hartford, CT

Sources for this page

Verify at the official NPI Registry.