Individual provider Active NPI

Andrea Rodriguez

  • Acute Care Nurse Practitioner
  • El Paso, TX
National Provider Identifier
1508595976
Registry record updated Jun 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1023725 Issued in TX
Practice address
1200 Golden Key Cir Ste 230
El Paso, TX 79925-5834
Phone
(915) 990-3670
NPI assigned
Jun 9, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1023725 TX Primary

Addresses

Primary practice location

1200 Golden Key Cir Ste 230
El Paso, TX 79925-5834

Mailing address

1200 Golden Key Cir Ste 230
El Paso, TX 79925-5834
Phone (915) 990-3670

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address andre.680@icloud.com

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
I20220622003164 TX Practitioner - Nurse Practitioner 3678952504 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Los Cerros Medical LLC CurrentSince Sep 7, 2024 Accepting new patients

Locations

812 N Virginia St
Ste 211B
El Paso, TX 79902
Phone (915) 218-1930

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.

NPI Registry JSON

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

{
    "created_epoch": "1654732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1508595976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 GOLDEN KEY CIR STE 230",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799255834",
            "telephone_number": "915-990-3670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 GOLDEN KEY CIR STE 230",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799255834",
            "telephone_number": "915-990-3670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "ANDREA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-09",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1023725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "andre.680@icloud.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "address_1": "1200 Golden Key Cir Ste 230",
            "city": "El Paso",
            "state": "TX",
            "country_code": "US",
            "postal_code": "799255834",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.