Individual provider Active NPI

Ana I Rodriguez

  • Psychiatry Physician
  • Temple Terrace, FL
National Provider Identifier
1417072257
Registry record updated Mar 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME134779 Issued in FL
Practice address
13067 N Telecom Pkwy
Temple Terrace, FL 33637-0926
Phone
(813) 773-6658
NPI assigned
Mar 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 242685 NY
Psychiatry Physician 2084P0800X ME134779 FL Primary

Addresses

Primary practice location

13067 N Telecom Pkwy
Temple Terrace, FL 33637-0926

Mailing address

2060 Grand Concourse Apt 4F
Bronx, NY 10457-2847

Other identifiers 1

IdentifierTypeStateIssuer
242685MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL, DC3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20111103000493 NY Practitioner - Psychiatry 7618140898 Reassigns benefits to 2 organizations
I20180516001649 FL Practitioner - Psychiatry 7618140898 Reassigns benefits to 2 organizations
I20230907000550 DC Practitioner - Psychiatry 7618140898 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MCCD FL Psychiatry Services PAGroup PAC ID 4880064070, 751 clinicians

Practice addresses (Care Compare)

1301 Riverplace Blvd
Suite 800
Jacksonville, FL 32207-9032
Phone (833) 351-8255

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME134779FLMDPsychiatry Physician
242685NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Charities Neighborhood Services, Inc. CurrentSince Sep 22, 2011 Accepting new patients
MCCD Psychiatry Services PLLC Psychiatry CurrentSince Aug 11, 2023 Accepting new patients
MCCD FL Psychiatry Services PA Psychiatry CurrentSince Aug 11, 2023 Accepting new patients
Pioneer Medical Group, PL Psychiatry CurrentSince May 30, 2018 Accepting new patients
Catholic Charities Neigborhood Services Past Accepting new patients

Locations

1301 Riverplace Blvd
Jacksonville, FL 32207

1301 Riverplace Blvd
Ste 800
Jacksonville, FL 32207
Phone (904) 567-6040

13067 N Telecom Pkwy
Temple Terrace, FL 33637
Phone (813) 333-9108

38250 A Ave
Zephyrhills, FL 33542
Phone (813) 732-5608

191 Joralemon St
Fl 11
Brooklyn, NY 11201

6729 Myrtle Ave
Glendale, NY 11385
Phone (718) 456-7001

109 W 27th St
Rm 5S
New York, NY 10001
Phone (332) 230-4572

109 W 27th St
#55
New York, NY 10001

2800 Eisenhower Ave
Ste 220
Alexandria, VA 22314
Phone (540) 358-0423

Organizations & group practices 5

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": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553558400000",
    "number": "1417072257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2060 GRAND CONCOURSE APT 4F",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104572847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13067 N TELECOM PKWY",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336370926",
            "telephone_number": "813-773-6658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "ANA",
        "middle_name": "I",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2019-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "242685",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME134779",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "242685",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple Terrace, FL

Sources for this page

Verify at the official NPI Registry.