Individual provider Active NPI

Marlene Rodriguez, MD

  • Pediatrics Physician
  • Tucson, AZ
National Provider Identifier
1629178975
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
42628 Issued in AZ
Practice address
6950 E Golf Links Rd
Tucson, AZ 85730-1017
Phone
(520) 670-3909
Fax
(520) 309-2560
NPI assigned
Sep 25, 2006
Last updated
Jan 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 42628 AZ Primary
Pediatrics Physician 208000000X A84528 CA

Addresses

Primary practice location

6950 E Golf Links Rd
Tucson, AZ 85730-1017

Mailing address

839 W Congress St
Tucson, AZ 85745-2819
Phone (520) 670-3909

Other identifiers 4

IdentifierTypeStateIssuer
HAP71021FOtherCAFPACT
ZZZ29799ZOtherCAFQHC MEDICARE PART B
FHC71021FMedicaidCA
55-1975OtherCAFQHC MEDICARE PART A

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20130204000381 AZ Practitioner - Pediatric Medicine 3577731512 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42628AZMDPediatrics Physician
A84528CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
El Rio Santa Cruz Neighborhood Health Center, Inc CurrentSince Dec 1, 2012 Accepting new patients
El Rio Santa Cruz Neighborhood Health Center, Inc CurrentSince Dec 1, 2012 Accepting new patients
El Rio Santa Cruz Neighborhood Health Center Past Accepting new patients
El Rio Santa Cruz Neighborhood Health Center, Inc Past Accepting new patients

Locations

101 W Irvington Rd
Tucson, AZ 85714
Phone (520) 670-3707

101 W Irvington Rd
Bldg 10
Tucson, AZ 85714
Phone (520) 309-4585

1500 W Commerce Ct
Tucson, AZ 85746
Phone (520) 309-3601

1500 W Commerce Ct
Bldg 12
Tucson, AZ 85746

320 W Prince Rd
Tucson, AZ 85705
Phone (520) 838-7663

6950 E Golf Links Rd
Tucson, AZ 85730
Phone (520) 309-3225

839 W Congress St
Tucson, AZ 85745
Phone (520) 670-3707

Interoperability endpoints

  • Direct secure messaging: mrodriguez18304@elrio.direct.ci.com

Organizations & group practices 4

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": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1629178975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "839 W CONGRESS ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857452819",
            "telephone_number": "520-670-3909",
            "fax_number": "520-309-2560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6950 E GOLF LINKS RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857301017",
            "telephone_number": "520-670-3909",
            "fax_number": "520-309-2560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "MARLENE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "42628",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A84528",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FPACT",
            "identifier": "HAP71021F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FQHC MEDICARE PART B",
            "identifier": "ZZZ29799Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FHC71021F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FQHC MEDICARE PART A",
            "identifier": "55-1975",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.