Individual provider Active NPI

Angelica Maria Rodriguez, AU.D.

  • Audiologist
  • Roswell, NM
National Provider Identifier
1669749552
Registry record updated Jul 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
4960 Issued in NM
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

Updated by the provider on Jul 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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 Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
4960NMMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Angelica Audiology, LLC CurrentSince Aug 5, 2014 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.

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.

Verify at the official NPI Registry.