Individual provider Active NPI

Mario Rodriguez, FNP

  • Family Nurse Practitioner
  • Mission, TX
National Provider Identifier
1487302907
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1073980 Issued in TX
Practice address
104 S Bryan Rd
Mission, TX 78572-6218
Phone
(956) 585-1691
NPI assigned
Mar 14, 2022
Last updated
Jan 25, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X TEMP TX
Family Nurse Practitioner 363LF0000X 1073980 TX Primary

Addresses

Primary practice location

104 S Bryan Rd
Mission, TX 78572-6218

Mailing address

502 S Closner Blvd
Edinburg, TX 78539-4660
Phone (956) 292-0100

Other practice location 1

502 S Closner Blvd
Edinburg, TX 78539-4660
Phone (956) 292-0100

Other practice location 2

104 S Bryan Rd
Mission, TX 78572-6218
Phone (956) 585-1691

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
I20220425001919 TX Practitioner - Nurse Practitioner 7517354368 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1073980TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Monzer H Yazji MD & Associates PLLC CurrentSince Mar 30, 2022 Accepting new patients

Locations

502 S Closner Blvd
Edinburg, TX 78539
Phone (956) 292-0100

104 S Bryan Rd
Mission, TX 78572
Phone (956) 271-4950

1920 E Griffin Pkwy
Mission, TX 78572
Phone (956) 584-3353

Interoperability endpoints

  • Direct secure messaging: mario.rodriguez@415054778073092.direct.elationemr.com
  • Direct secure messaging: mario.rodriguez@yazjimd.directbygreenway.com

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, 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": "1647216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1487302907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 S CLOSNER BLVD",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785394660",
            "telephone_number": "956-292-0100",
            "fax_number": "956-383-1906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 S BRYAN RD",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785726218",
            "telephone_number": "956-585-1691"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "502 S Closner Blvd",
            "address_purpose": "LOCATION",
            "city": "Edinburg",
            "state": "TX",
            "postal_code": "785394660",
            "country_code": "US",
            "telephone_number": "956-292-0100",
            "fax_number": "956-383-1906",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "104 S Bryan Rd",
            "address_purpose": "LOCATION",
            "city": "Mission",
            "state": "TX",
            "postal_code": "785726218",
            "country_code": "US",
            "telephone_number": "956-585-1691",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "MARIO",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-14",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "TEMP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1073980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission, TX

Sources for this page

Verify at the official NPI Registry.