Individual provider Active NPI

Audrey Diane Rodriguez, P.A.

  • Physician Assistant
  • San Antonio, TX
National Provider Identifier
1497051478
Registry record updated Nov 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA06859 Issued in TX
Practice address
9102 Floyd Curl Dr
San Antonio, TX 78240-1553
Phone
(210) 782-9528
Fax
(512) 597-0841
NPI assigned
Feb 8, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2016

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 PA06859 TX Primary

Addresses

Primary practice location

9102 Floyd Curl Dr
San Antonio, TX 78240-1553

Mailing address

215 E Quincy St
Suite B100
San Antonio, TX 78215-2039
Phone (210) 299-8000

Other identifiers 1

IdentifierTypeStateIssuer
TXB157669OtherTXMEDICARE PTAN

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
I20120806000352 TX Practitioner - Physician Assistant 9234385337 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rise Up Rehab, LLCGroup PAC ID 3274861497, 118 clinicians
Ear Medical Group PAGroup PAC ID 4880635556, 7 clinicians

Practice addresses (Care Compare)

16400 Blanco Rd
San Antonio, TX 78232-1902
Phone (210) 572-4954

21 Spurs LN
Suite 245
San Antonio, TX 78240-1689
Phone (210) 614-6070

Hospital & facility affiliations

  • Baptist Medical Center Hospital, San Antonio, TX, CCN 450058
  • University Health System Hospital, San Antonio, TX, CCN 450213

Merit-based Incentive Payment System (MIPS)

Final score
88.34 of 100Reported as group
Quality
87.32
Improvement activities
40
Cost
78.05

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hillside Primary Care PLLC Past Accepting new patients
Radiation Oncology of San Antonio, PA Past Accepting new patients

Organizations & group practices 4

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": "1297123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479254400000",
    "number": "1497051478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 E QUINCY ST",
            "address_2": "SUITE B100",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782152039",
            "telephone_number": "210-299-8000",
            "fax_number": "210-299-8099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9102 FLOYD CURL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782401553",
            "telephone_number": "210-782-9528",
            "fax_number": "512-597-0841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "AUDREY",
        "middle_name": "DIANE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-08",
        "last_updated": "2016-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA06859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "TXB157669",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.