Michael Alex Rodriguez

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC06057200 Issued in NJ

Practice address

206 Gentry CT
Pennington, NJ 08534-5251

Phone

(908) 318-4950

NPI assigned

Jan 22, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Shine Medical Providers PC

  • Psychiatry Physician
  • Philadelphia, PA
  • NPI 1538894050
  NPD (past)

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

{
    "created_epoch": "1642809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1508518390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 GENTRY CT",
            "city": "PENNINGTON",
            "state": "NJ",
            "postal_code": "085345251",
            "telephone_number": "609-533-7261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 GENTRY CT",
            "city": "PENNINGTON",
            "state": "NJ",
            "postal_code": "085345251",
            "telephone_number": "908-318-4950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "MICHAEL",
        "middle_name": "ALEX",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-01-22",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "095839",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC06057200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristy D. Reed, A.N.P.
• Regenespine, LLC
• Shannon Lynn Renitsky, APN
• Jennifer Rey, P.A.-C
• Scarlin A Rhoades, NP
• Noreen Barbara Rodriguez, APN,C
• Jason N Rogart, MD
• Brad S Rogers, MD
• Katharine Rose Roman, LSW
• Mark Patrick Romanowski, MD

• Clinical Social Worker in Pennington, NJ
• Providers in Pennington, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.