Individual provider Active NPI

Omar Alfonso Rodriguez Burgos, MD

  • Student in an Organized Health Care Education/Training Program
  • Des Moines, IA
National Provider Identifier
1568210391
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1801 Hickman Rd
Des Moines, IA 50314-1597
Phone
(515) 282-8549
NPI assigned
May 7, 2024
Last updated
May 7, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1801 Hickman Rd
Des Moines, IA 50314-1597

Mailing address

1801 Hickman Rd
Des Moines, IA 50314-1597
Phone (515) 282-8549

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20240627002722 IA Order and Referring Only - PsychiatryPractitioner - Psychiatry 9830633155

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Methodist Hospital Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: omar.rodriguez.1@11667.direct.athenahealth.com
  • Direct secure messaging: orodriguez1073241@direct.unitypoint.org

Organizations & group practices 1

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": "1715040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1568210391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 HICKMAN RD",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503141597",
            "telephone_number": "515-282-8549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 HICKMAN RD",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503141597",
            "telephone_number": "515-282-8549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ BURGOS",
        "first_name": "OMAR",
        "middle_name": "ALFONSO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-07",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.