Individual provider Active NPI

Ryan Michael Rodriguez, PA-C, ATC

  • Physician Assistant
  • El Paso, TX
National Provider Identifier
1669660882
Registry record updated Jun 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA15056 Issued in TX
Practice address
820 E Redd Rd BLDG B
El Paso, TX 79912-7275
Phone
(915) 581-0712
Fax
(915) 581-0712
NPI assigned
Oct 12, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 60229753 WA
Physician Assistant 363A00000X PA15056 TX Primary

Addresses

Primary practice location

820 E Redd Rd BLDG B
El Paso, TX 79912-7275

Mailing address

820 E Redd Rd BLDG B
El Paso, TX 79912-7275
Phone (915) 581-0712

Other practice location 1

1387 George Dieter Dr Ste 160D
El Paso, TX 79936-7410
Phone (915) 581-0712

Other identifiers 1

IdentifierTypeStateIssuer
PA15056OtherTXTEXAS MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220425000847 TX Practitioner - Physician Assistant 6204223134 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sun City Orthopaedic and Hand Surgery Specialists PLLCGroup PAC ID 4587827506, 14 clinicians

Practice addresses (Care Compare)

1387 George Dieter Dr
Suite 106D
El Paso, TX 79936-7410
Phone (915) 581-0712

820 E Redd Rd
BLDG B
El Paso, TX 79912-7275
Phone (915) 581-0712

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60229753WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sun City Orthopaedic & Hand Surgery Specialists PLLC CurrentSince Mar 15, 2022 Accepting new patients

Locations

1387 George Dieter Dr
Ste 106D
El Paso, TX 79936
Phone (915) 581-0712

820 E Redd Rd
Bldg B
El Paso, TX 79912
Phone (915) 581-0712

1400 George Dieter Dr
Ste 100
El Paso, TX 79936
Phone (915) 247-3150

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1192147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1669660882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 E REDD RD BLDG B",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799127275",
            "telephone_number": "915-581-0712",
            "fax_number": "915-533-8680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 E REDD RD BLDG B",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799127275",
            "telephone_number": "915-581-0712",
            "fax_number": "915-581-0712"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1387 George Dieter Dr Ste 160D",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799367410",
            "country_code": "US",
            "telephone_number": "915-581-0712",
            "fax_number": "915-833-7312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "RYAN",
        "middle_name": "MICHAEL",
        "credential": "PA-C, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-12",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "60229753",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA15056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS MEDICAL LICENSE",
            "identifier": "PA15056",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.