Individual provider Active NPI

Enrique Javier Rodriguez Jr.

  • Medical Physician Assistant
  • San Antonio, TX
National Provider Identifier
1487326997
Registry record updated Sep 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA14770 Issued in TX
Practice address
21 Spurs Lane Suite 240
San Antonio, TX 78240
Phone
(210) 690-0777
NPI assigned
Oct 3, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA14770 TX Primary

Addresses

Primary practice location

21 Spurs Lane Suite 240
San Antonio, TX 78240

Mailing address

21 Spurs LN Ste 240
San Antonio, TX 78240-1671
Phone (210) 690-0777

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
I20211012003408 TX Practitioner - Physician Assistant 6507264108 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ellen W Lin MD PAGroup PAC ID 2961589916, 7 clinicians

Practice addresses (Care Compare)

21 Spurs Lane
Suite 240
San Antonio, TX 78240-1671

21 Spurs LN
San Antonio, TX 78240-1671
Phone (210) 690-0777

255 E Sonterra Blvd
Suite 203
San Antonio, TX 78258-4076
Phone (210) 690-0777

Hospital & facility affiliations

  • Jonsan Home Health Inc. Home health agency, Schertz, TX, CCN 747983
  • Baptist Medical Center Hospital, San Antonio, TX, CCN 450058

Merit-based Incentive Payment System (MIPS)

Final score
86 of 100Reported as individual
Quality
86.59
Promoting interoperability
97
Improvement activities
40
Cost
69.24

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
MJF Rehabilitation PA PastSince Oct 10, 2021 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: enrique.rodriguez.1@9126.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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1633219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1487326997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 SPURS LN STE 240",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782401671",
            "telephone_number": "210-690-0777",
            "fax_number": "210-696-6376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 SPURS LANE SUITE 240",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78240",
            "telephone_number": "210-690-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "ENRIQUE",
        "middle_name": "JAVIER",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-03",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA14770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.