Individual provider Active NPI

Delaney Rodriguez, FNP

  • Family Nurse Practitioner
  • New Smyrna Beach, FL
National Provider Identifier
1427690890
Registry record updated Dec 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11018330 Issued in FL
Practice address
1055 N Dixie Fwy
New Smyrna Beach, FL 32168-6201
Phone
(386) 423-0505
NPI assigned
Oct 17, 2019
Last updated
Dec 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11018330 FL Primary
Registered Nurse 163W00000X 9450640 FL

Addresses

Primary practice location

1055 N Dixie Fwy
New Smyrna Beach, FL 32168-6201

Mailing address

1055 N Dixie Fwy
New Smyrna Beach, FL 32168-6201

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240827004709 FL Practitioner - Nurse Practitioner 0446799068 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Univ of Central Florida, College of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PCCC of Volusia LLCGroup PAC ID 7911910237, 15 clinicians

Practice addresses (Care Compare)

1055 N Dixie Fwy
Suite 1
New Smyrna Beach, FL 32168-6201
Phone (386) 423-0505

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9450640FLMDRegistered Nurse
11018330FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
PCCC of Volusia LLC CurrentSince Jul 1, 2024 Accepting new patients
NDC of Volusia LLC PastSince Dec 24, 2023 Accepting new patients

Locations

1055 N Dixie Fwy
Ste 1
New Smyrna Beach, FL 32168
Phone (386) 423-0505

780 Dunlawton Ave
Ste 1
Port Orange, FL 32127
Phone (386) 222-6111

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: delaney.rodriguez@pccc.directbygreenway.com
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71631

Organizations & group practices 2

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": "1571270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703116800000",
    "number": "1427690890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 N DIXIE FWY",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321686201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 N DIXIE FWY",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321686201",
            "telephone_number": "386-423-0505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "DELANEY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-17",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11018330",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9450640",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Smyrna Beach, FL

Sources for this page

Verify at the official NPI Registry.