Organization Active NPI

Juan L Rocha DPM

  • Foot & Ankle Surgery Podiatrist
  • Brownsville, TX
National Provider Identifier
1508055161
Registry record updated Sep 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
1747 Issued in TX
Legal business name
JUAN L ROCHA DPM
Practice address
110 Plaza Santa Rosa
Brownsville, TX 78520-9785
Phone
(956) 554-3010
Fax
(956) 986-2624
NPI assigned
Oct 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2008

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

Authorized official

Name
Edwin Byron Newton
Title
Biller
Phone
(956) 986-0704

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X 1747 TX Primary

Addresses

Primary practice location

110 Plaza Santa Rosa
Brownsville, TX 78520-9785

Mailing address

PO Box 4007
Brownsville, TX 78523-4007
Phone (956) 554-3010

Other identifiers 1

IdentifierTypeStateIssuer
180508701MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050927000122 TX Part B Supplier - Clinic/Group Practice 5496789638 Receives reassigned benefits from 1 practitioner
Practice locations: Falfurrias, TX; Rio Grande City, TX; McAllen, TX; Brownsville, TX

National Provider Directory

National Provider Directory

Locations

425 E Los Ebanos Blvd
Ste 108
Brownsville, TX 78520
Phone (956) 542-9778

5235 Southmost Rd
Ste F
Brownsville, TX 78521
Phone (956) 546-9494

1400 S St Marys St
Falfurrias, TX 78355
Phone (361) 325-1910

2751 Pharmacy Rd
Ste B
Rio Grande Cy, TX 78582
Phone (956) 716-6400

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1192752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222646400000",
    "number": "1508055161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4007",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785234007",
            "telephone_number": "956-554-3010",
            "fax_number": "956-986-2624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 PLAZA SANTA ROSA",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785209785",
            "telephone_number": "956-554-3010",
            "fax_number": "956-986-2624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUAN L ROCHA DPM",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-19",
        "last_updated": "2008-09-29",
        "status": "A",
        "authorized_official_last_name": "NEWTON",
        "authorized_official_first_name": "EDWIN",
        "authorized_official_middle_name": "BYRON",
        "authorized_official_title_or_position": "BILLER",
        "authorized_official_telephone_number": "956-986-0704"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "TX",
            "license": "1747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "180508701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brownsville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.