Individual provider Active NPI

Georgette Rodriguez, MD

  • Dermatology Physician
  • Miami, FL
National Provider Identifier
1457467672
Registry record updated Jun 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
ME95752 Issued in FL
Practice address
5600 SW 87TH St
Miami, FL 33143-8315
Phone
(941) 468-2719
Fax
(305) 663-1156
NPI assigned
Aug 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X ME95752 FL Primary

Addresses

Primary practice location

5600 SW 87TH St
Miami, FL 33143-8315

Mailing address

5600 SW 87TH St
Miami, FL 33143-8315
Phone (305) 661-0093

Other identifiers 1

IdentifierTypeStateIssuer
ME95752OtherFLMEDICAL LICENSE

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
I20061213000299 FL Practitioner - Dermatology 1254330673 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Florida College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6351 Sunset Dr
Miami, FL 33143-4842
Phone (305) 667-5480

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions698
Removal of nail tissue1-10
Skin biopsy130

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME95752FLMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Miami Dermatology PA Dermatology CurrentSince May 18, 2009 Accepting new patients

Locations

6351 Sunset Dr
South Miami, FL 33143
Phone (305) 667-5480

6351 Sunset Dr
Ste 200
South Miami, FL 33143
Phone (305) 667-5480

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246233600000",
    "number": "1457467672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5600 SW 87TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331438315",
            "telephone_number": "305-661-0093",
            "fax_number": "305-663-1156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 SW 87TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331438315",
            "telephone_number": "941-468-2719",
            "fax_number": "305-663-1156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "GEORGETTE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2009-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME95752",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "ME95752",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.