Active NPI
Angelica Maria Rodriguez, AU.D.
- Audiologist
- Roswell, NM
National Provider Identifier
1669749552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 4960
- Practice address
- 1000 W 4TH St
Roswell, NM 88201-3038 - Phone
- (575) 623-8474
- Fax
- (575) 623-8220
- NPI assigned
- Nov 21, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 4960 | NM | Primary |
Addresses
Primary practice location
1000 W 4TH St
Roswell, NM 88201-3038
Mailing address
1000 W 4TH St
Roswell, NM 88201-3038
Phone (575) 623-8474
Other names 1
- Dr. Angelica Maria Gonzalez
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120127000663 | NM | Practitioner - Qualified Audiologist | 8224295514 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Qualified Audiologist
- Education
- Texas Tech University Health Science Center School of Medicine, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2420 W Pierce St
Suite 102
Carlsbad, NM 88220-3517
Phone (575) 623-8474
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4960 | NM | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Angelica Audiology, LLC | Current | Accepting new patients | |
| Pecos Valley of New Mexico, LLC | Past | Accepting new patients |
Locations
2420 W Pierce St
Ste 102
Carlsbad, NM 88220
Phone (575) 623-8474
1000 W 4th St
Roswell, NM 88201
Phone (505) 623-8474
Organizations & group practices 2
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.
-
- General Practice Physician
- Carlsbad, NM
- NPI 1972569820
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1321833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405296000000",
"number": "1669749552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 W 4TH ST",
"city": "ROSWELL",
"state": "NM",
"postal_code": "882013038",
"telephone_number": "575-623-8474",
"fax_number": "575-623-8220"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 W 4TH ST",
"city": "ROSWELL",
"state": "NM",
"postal_code": "882013038",
"telephone_number": "575-623-8474",
"fax_number": "575-623-8220"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "ANGELICA",
"middle_name": "MARIA",
"name_prefix": "Dr.",
"credential": "AU.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-11-21",
"last_updated": "2014-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "NM",
"license": "4960",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ANGELICA",
"last_name": "GONZALEZ",
"middle_name": "MARIA",
"prefix": "DR.",
"credential": "AU.D.",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Roswell, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.