Robert Rodriguez, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9106554 Issued in FL

Practice address

216 Frederick St
Pierson, FL 32180-3024

Phone

(386) 749-9449

Fax

(386) 749-2280

NPI assigned

May 15, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northeast Florida Health Services, IncGroup PAC ID 0547249518, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: robert.rodriguez@nefhs.eclinicaldirectplus.com

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.

• Northeast Florida Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Pierson, FL
  • NPI 1992792311
  Medicare reassignment Care Compare group
• Northeast Florida Health Services Inc

  • Federally Qualified Health Center (FQHC)
  • Deltona, FL
  • NPI 1427605534
  NPD
• Northeast Florida Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • South Daytona, FL
  • NPI 1396282208
  NPD
• Garg Medical Center Inc

  • Internal Medicine Physician
  • Largo, FL
  • NPI 1154515054
  NPD (past)

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

{
    "created_epoch": "1337040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1619236338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 S WOODLAND BLVD STE 3",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327207464",
            "telephone_number": "386-202-6025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 FREDERICK ST",
            "city": "PIERSON",
            "state": "FL",
            "postal_code": "321803024",
            "telephone_number": "386-749-9449",
            "fax_number": "386-749-2280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "ROBERT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-15",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9106554",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009036300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jada Miller
• Northeast Florida Health Services, Inc.
• Northeast Florida Health Services, Inc.
• Pierson Community Pharmacy Inc
• Shrimani Reddy, MD
• Trittschuh Physical Therapy Inc

• Medical Physician Assistant in Pierson, FL
• Providers in Pierson, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.