Individual provider Active NPI

Alexis Phyllip Rodriguez

  • Internal Medicine Physician
  • Miami, FL
National Provider Identifier
1669748570
Registry record updated Nov 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME128507 Issued in FL
Practice address
1611 NW 12TH Ave
Central Building, Room 600D (R-60)
Miami, FL 33136-1005
Phone
(305) 585-5215
NPI assigned
Mar 25, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME128507 FL Primary

Addresses

Primary practice location

1611 NW 12TH Ave
Central Building, Room 600D (R-60)
Miami, FL 33136-1005

Mailing address

PO Box 12493
Miami, FL 33101-2493
Phone (305) 585-5315

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20241127001141 SC Practitioner - Internal Medicine 5395005441 Reassigns benefits to 4 organizations
I20260316002798 VA Practitioner - Cardiovascular Disease (Cardiology) 5395005441 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Miami, LM Miller School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLeod Loris Seacoast HospitalGroup PAC ID 9133394398, 57 clinicians
McLeod Regional Medical Center of the Pee Dee IncGroup PAC ID 7416851852, 401 clinicians

Practice addresses (Care Compare)

3655 Mitchell St
Loris, SC 29569-2827
Phone (843) 716-7111

555 E Cheves St
Florence, SC 29506-2617
Phone (843) 777-2000

Hospital & facility affiliations

  • McLeod Regional Medical Center-Pee Dee Hospital, Florence, SC, CCN 420051
  • McLeod Loris Hospital Hospital, Loris, SC, CCN 420105

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
McLeod Medical Center-Dillon CurrentSince Sep 1, 2024 Accepting new patients
Riverside Physician Services, Inc. Internal Medicine CurrentSince Mar 11, 2026 Accepting new patients
McLeod Regional Medical Center of the Pee Dee, Inc Internal Medicine CurrentSince Sep 1, 2024 Accepting new patients
McLeod Health Clarendon CurrentSince Sep 1, 2024 Accepting new patients
McLeod Medical Center-Dillon CurrentSince Sep 1, 2024 Accepting new patients
McLeod Health Clarendon CurrentSince Sep 1, 2024 Accepting new patients
Riverside Physician Services Inc CurrentSince Mar 11, 2026 Accepting new patients
McLeod Loris Seacoast Hospital CurrentSince Sep 1, 2024 Accepting new patients
McLeod Regional Medical Center of the Pee Dee, Inc CurrentSince Sep 1, 2024 Accepting new patients
McLeod Loris Seacoast Hospital CurrentSince Sep 1, 2024 Accepting new patients

Locations

301 E Jackson St
Dillon, SC 29536
Phone (843) 774-1166

555 E Cheves St
Florence, SC 29506
Phone (843) 662-5233

3655 Mitchell St
Loris, SC 29569
Phone (843) 716-7000

10 E Hospital St
Manning, SC 29102
Phone (803) 433-3000

12200 Warwick Blvd
Ste 590B
Newport News, VA 23601
Phone (757) 534-5909

19375 Benns Grant Blvd
Smithfield, VA 23430
Phone (757) 674-8700

Organizations & group practices 11

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": "1332633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511049600000",
    "number": "1669748570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12493",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331012493",
            "telephone_number": "305-585-5315",
            "fax_number": "305-355-2242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 NW 12TH AVE",
            "address_2": "CENTRAL BUILDING, ROOM 600D (R-60)",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361005",
            "telephone_number": "305-585-5215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "ALEXIS",
        "middle_name": "PHYLLIP",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-25",
        "last_updated": "2017-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME128507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.