Individual provider Active NPI

Anielka Rafaela Rodriguez, M.D.

  • Family Medicine Physician
  • Fern Park, FL
National Provider Identifier
1487968764
Registry record updated Mar 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME117966 Issued in FL
Practice address
2915 Lakeview Dr Ste 1001
Fern Park, FL 32730-2009
Phone
(407) 900-0613
Fax
(407) 335-6945
NPI assigned
Jul 29, 2010
Last updated
Mar 25, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME117966 FL Primary

Addresses

Primary practice location

2915 Lakeview Dr Ste 1001
Fern Park, FL 32730-2009

Mailing address

3300 S Fiske Blvd
Rockledge, FL 32955-4306
Phone (407) 900-0613

Other identifiers 1

IdentifierTypeStateIssuer
NH879OtherFLFL MEDICARE

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
I20131107000430 FL Practitioner - Family Practice 1658506225 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Health First Privia Medical GroupGroup PAC ID 3173965993, 247 clinicians

Practice addresses (Care Compare)

140 6TH Ave
Indialantic, FL 32903-3204
Phone (321) 312-3501

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME117966FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc Family Medicine CurrentSince Nov 4, 2013 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Nov 4, 2013 Accepting new patients
Privia Medical Group Florida, LLC CurrentSince Jan 1, 2025 Accepting new patients

Locations

1101 S Eustis St
Eustis, FL 32726
Phone (352) 589-4111

2915 Lakeview Dr
Ste 1001
Fern Park, FL 32730
Phone (407) 900-0613

140 6th Ave
Indialantic, FL 32903
Phone (321) 312-3501

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

3300 S Fiske Blvd
Rockledge, FL 32955
Phone (321) 434-1771

989 Sebastian Blvd
Unit 3
Sebastian, FL 32958
Phone (727) 617-1777

Interoperability endpoints

  • Direct secure messaging: anielka.rodriguez.1@8042.direct.athenahealth.com

Organizations & group practices 3

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 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": "1280361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1487968764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 S FISKE BLVD",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329554306",
            "telephone_number": "407-900-0613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2915 LAKEVIEW DR STE 1001",
            "city": "FERN PARK",
            "state": "FL",
            "postal_code": "327302009",
            "telephone_number": "407-900-0613",
            "fax_number": "407-335-6945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "ANIELKA",
        "middle_name": "RAFAELA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-29",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME117966",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL MEDICARE",
            "identifier": "NH879",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fern Park, FL

Sources for this page

Verify at the official NPI Registry.