NPIMap

Individual provider Active NPI

Elena Mayra Rodriguez, PA-C

  • Physician Assistant
  • Gun Barrel City, TX
National Provider Identifier
1629466834
Registry record updated Oct 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA09549 Issued in TX
Practice address
170 Municipal Dr
Gun Barrel City, TX 75156-3704
Phone
(903) 887-7992
Fax
(903) 887-7996
NPI assigned
Dec 23, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA09549 TX Primary

Addresses

Primary practice location

170 Municipal Dr
Gun Barrel City, TX 75156-3704

Mailing address

117 Medical Cir
Athens, TX 75751-9003
Phone (903) 676-3200

Other practice location 1

117 Medical Cir
Athens, TX 75751-9003
Phone (903) 676-3200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180405002349 TX Practitioner - Physician Assistant 6002179918 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lakeland Medical AssociatesGroup PAC ID 2567476146, 16 clinicians

Practice addresses (Care Compare)

117 Medical Cir
Athens, TX 75751-9003
Phone (903) 676-3200

170 Municipal Dr
Gun Barrel City, TX 75156-3704
Phone (903) 887-7992

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
60.68 of 100Reported as group
Quality
79.58
Promoting interoperability
0
Improvement activities
40
Cost
72.68

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Topcare Medical PA PastSince Apr 2, 2012 Accepting new patients
Tyler Family Circle of Care PastSince Jan 19, 2025 Accepting new patients
Athens Hospital, LLC PastSince Oct 8, 2023 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: erodriguez155203@christushealth.direct-ci.net
  • Direct secure messaging: elena.rodriguez.1@31619.direct.athenahealth.com

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": "1419292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696464000000",
    "number": "1629466834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 MEDICAL CIR",
            "city": "ATHENS",
            "state": "TX",
            "postal_code": "757519003",
            "telephone_number": "903-676-3200",
            "fax_number": "903-676-3277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 MUNICIPAL DR",
            "city": "GUN BARREL CITY",
            "state": "TX",
            "postal_code": "751563704",
            "telephone_number": "903-887-7992",
            "fax_number": "903-887-7996"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "117 Medical Cir",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "TX",
            "postal_code": "757519003",
            "country_code": "US",
            "telephone_number": "903-676-3200",
            "fax_number": "903-676-3277",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "ELENA",
        "middle_name": "MAYRA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-23",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA09549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gun Barrel City, TX

Sources for this page

Verify at the official NPI Registry.