Individual provider Active NPI

Barnie P. Rodriguez, P.A.

  • Physician Assistant
  • Roswell, NM
National Provider Identifier
1639395221
Registry record updated Oct 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
93-PA21 Issued in NM
Practice address
1700 N Union Ave
Roswell, NM 88201-3267
Phone
(575) 623-1303
Fax
(575) 623-1903
NPI assigned
Apr 18, 2007
Last updated
Oct 24, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2019

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 93-PA21 NM Primary

Addresses

Primary practice location

1700 N Union Ave
Roswell, NM 88201-3267

Mailing address

PO Box 1974
Roswell, NM 88202-1974
Phone (575) 623-1303

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20090901000396 NM Practitioner - Physician Assistant 3678628336 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Elite Medical LLCGroup PAC ID 6103071428, 2 clinicians

Practice addresses (Care Compare)

1525 N Renaissance Blvd NE
Albuquerque, NM 87107-6827
Phone (575) 623-1303

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
93-PA21NMMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Jack L Graham, MD, PC Past Accepting new patients
Whole World Health Care, PC Past Accepting new patients

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571875200000",
    "number": "1639395221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1974",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882021974",
            "telephone_number": "575-623-1303",
            "fax_number": "575-622-1903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 N UNION AVE",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882013267",
            "telephone_number": "575-623-1303",
            "fax_number": "575-623-1903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "BARNIE",
        "middle_name": "P.",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2019-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "93-PA21",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, NM

Sources for this page

Verify at the official NPI Registry.