Individual provider Active NPI

Jose R Rodriguez, P.A.

  • Physician Assistant
  • Flower Mound, TX
National Provider Identifier
1437254679
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA04899 Issued in TX
Practice address
5000 Long Prairie Rd
Flower Mound, TX 75028-2783
Phone
(972) 420-1776
Fax
(972) 221-8685
NPI assigned
Sep 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA04899 TX Primary

Addresses

Primary practice location

5000 Long Prairie Rd
Flower Mound, TX 75028-2783

Mailing address

5000 Long Prairie Rd
Flower Mound, TX 75028-2783
Phone (972) 420-1776

Other identifiers 3

IdentifierTypeStateIssuer
1071690OtherTXNCCPA CERTIFICATION
D0171280OtherTXDPS REGISTRATION
PA04899OtherTXTX MEDICAL BOARD LICENSE/PERMIT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20070507000533 TX Practitioner - Physician Assistant 4183720295 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5000 Long Prairie Rd
Suite 100
Flower Mound, TX 75028-2783
Phone (972) 420-1776

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.1 of 100Reported as group
Quality
100
Promoting interoperability
97
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA04899TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Associates of Flower Mound PLLC CurrentSince Feb 17, 2024 Accepting new patients
Jorge Zamora-Quezada MD MPH PA Past Accepting new patients

Locations

1234 FM 407
Ste 100
Northlake, TX 76247

Interoperability endpoints

  • Direct secure messaging: jose.rodriguez.1@23106.direct.athenahealth.com
  • Direct secure messaging: jose.rodriguez.1@15749.direct.athenahealth.com

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.

Hospital & facility affiliations 1

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": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1437254679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 LONG PRAIRIE RD",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750282783",
            "telephone_number": "972-420-1776",
            "fax_number": "972-221-8685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 LONG PRAIRIE RD",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750282783",
            "telephone_number": "972-420-1776",
            "fax_number": "972-221-8685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JOSE",
        "middle_name": "R",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA04899",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA CERTIFICATION",
            "identifier": "1071690",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DPS REGISTRATION",
            "identifier": "D0171280",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX MEDICAL BOARD LICENSE/PERMIT",
            "identifier": "PA04899",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flower Mound, TX

Sources for this page

Verify at the official NPI Registry.