Individual provider Active NPI

Renne Rodriguez, FNP-BC

  • Family Nurse Practitioner
  • Brentwood, NY
National Provider Identifier
1588022578
Registry record updated Nov 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F345998-01 Issued in NY
Practice address
95 Helmig St
Brentwood, NY 11717-6723
Phone
(516) 757-2986
NPI assigned
Feb 4, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse First Assistant 163WR0006X 626436-1 NY
Family Nurse Practitioner 363LF0000X F345998-01 NY Primary

Addresses

Primary practice location

95 Helmig St
Brentwood, NY 11717-6723

Mailing address

95 Helmig St
Brentwood, NY 11717-6723
Phone (516) 757-2986

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20220309000138 NY Practitioner - Nurse Practitioner 0941694921 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

440 E Main St
Bay Shore, NY 11706-8501
Phone (516) 321-3000

Hospital & facility affiliations

  • North Shore University Hospital Hospital, Manhasset, NY, CCN 330106
  • Long Island Jewish Medical Center Hospital, New Hyde Park, NY, CCN 330195

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
626436-1NYMDRegistered Nurse First Assistant
345998NYMDLicensed Practical Nurse
F345998-01NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Jul 12, 2023 Accepting new patients
The Central Orthopedic Group L L P CurrentSince Jan 1, 2022 Accepting new patients
Optimum Health and Wellness CurrentSince Jun 1, 2022 Accepting new patients
The Central Orthopedic Group L L P CurrentSince Jan 1, 2022 Accepting new patients
North Shore - Lij Medical PC CurrentSince Jul 12, 2023 Accepting new patients

Locations

440 E Main St
Bay Shore, NY 11706
Phone (631) 414-2023

440 E Main St
Ste A
Bay Shore, NY 11706
Phone (520) 414-8000

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

101 Saint Andrews Ln
Glen Cove, NY 11542
Phone (516) 674-7300

284 Pulaski Rd
#2
Greenlawn, NY 11740
Phone (631) 271-1608

270 Pulaski Rd
Ste C
Greenlawn, NY 11740

270 Park Ave
Huntington, NY 11743
Phone (631) 351-2308

158 Jericho Tpke
Mineola, NY 11501
Phone (516) 526-6144

450 Lakeville Rd
North New Hyde Park, NY 11042
Phone (516) 321-3000

27005 76th Ave
North New Hyde Pk, NY 11040

651 Old Country Rd
Ste 200
Plainview, NY 11803
Phone (516) 681-8822

651 Old Country Rd
Plainview, NY 11803
Phone (516) 333-7200

300 Community Dr
Plandome, NY 11030

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: rennerodriguez@nslijmedgr.allscriptsdirect.net

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1454544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1588022578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 HELMIG ST",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117176723",
            "telephone_number": "516-757-2986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 HELMIG ST",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117176723",
            "telephone_number": "516-757-2986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "RENNE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-04",
        "last_updated": "2021-11-08",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "NY",
            "license": "626436-1",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F345998-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, NY

Sources for this page

Verify at the official NPI Registry.