Individual provider Active NPI

Carlos R Rodriguez, M.D.

  • Family Medicine Physician
  • Clearwater, FL
National Provider Identifier
1538164157
Registry record updated Aug 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME82799 Issued in FL
Practice address
14100 58TH St N
Clearwater, FL 33760-9900
Phone
(727) 824-8181
Fax
(727) 824-8150
NPI assigned
Jun 20, 2005
Last updated
Aug 4, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME82799 FL Primary
Sports Medicine (Family Medicine) Physician 207QS0010X ME82799 FL

Addresses

Primary practice location

14100 58TH St N
Clearwater, FL 33760-9900

Mailing address

14100 58TH St N
Clearwater, FL 33760-9900
Phone (727) 824-8181

Other identifiers 1

IdentifierTypeStateIssuer
265512800MedicaidFL

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
I20080819000738 FL Practitioner - Family PracticePractitioner - Sports Medicine 4880666817 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

14100 58TH St N
Suite 100
Clearwater, FL 33760-9900
Phone (727) 824-8181

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME82799FLMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health, Inc. Current Accepting new patients
Carlos a Labrador Mdpa Family Medicine CurrentSince Apr 1, 2020 Accepting new patients
Community Health Centers of Pinellas Inc. CurrentSince Sep 28, 2021 Accepting new patients
Community Health Center of Pinellas Inc Family Medicine CurrentSince Sep 28, 2021 Accepting new patients
Dodge Emergency Group LLC Past Accepting new patients
Ohi West Medical Group, LLC Past Accepting new patients

Locations

14100 58th St N
Clearwater, FL 33760

14100 58th St N
Ste 100
Clearwater, FL 33760
Phone (727) 286-6224

5523 Roosevelt Blvd
Clearwater, FL 33760

707 Druid Rd E
Clearwater, FL 33756
Phone (727) 461-1439

12420 130th Ave N
Largo, FL 33774
Phone (727) 587-7729

7550 43rd St N
Pinellas Park, FL 33781
Phone (727) 290-4222

1344 22nd St S
St Petersburg, FL 33712
Phone (727) 821-6701

4950 34th St N
St Petersburg, FL 33714

612 Dr Martin Luther King Jr St N
St Petersburg, FL 33705

6775 Crosswinds Dr N
St Petersburg, FL 33710
Phone (727) 381-8006

700 6th St S
St Petersburg, FL 33701
Phone (727) 893-6116

701 6th St S
St Petersburg, FL 33701
Phone (727) 450-1144

247 S Huey Ave
Tarpon Springs, FL 34689
Phone (727) 944-3828

Interoperability endpoints

  • Direct secure messaging: crodriguez188721@orlandohealth.medalliesdirect.net

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691107200000",
    "number": "1538164157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14100 58TH ST N",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337609900",
            "telephone_number": "727-824-8181",
            "fax_number": "727-824-8150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14100 58TH ST N",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337609900",
            "telephone_number": "727-824-8181",
            "fax_number": "727-824-8150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "CARLOS",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-20",
        "last_updated": "2023-08-04",
        "certification_date": "2021-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME82799",
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "FL",
            "license": "ME82799",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "265512800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.