Individual provider Active NPI

Rodolfo Laucirica, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Memphis, TN
National Provider Identifier
1679653075
Registry record updated Oct 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
19251 Issued in TN
Practice address
1265 Union Ave
Memphis, TN 38104-3415
Phone
(901) 516-7182
Fax
(901) 276-5474
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 19251 TN Primary

Addresses

Primary practice location

1265 Union Ave
Memphis, TN 38104-3415

Mailing address

1265 Union Ave
Memphis, TN 38104-3415
Phone (901) 516-7182

Other identifiers 2

IdentifierTypeStateIssuer
Q033049MedicaidTN
1679653075MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, TN, MS3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20110106001124 TX Practitioner - Pathology 6800085861 Reassigns benefits to 4 organizations
I20180131002293 TN Practitioner - Pathology 6800085861
I20190117003544 MS Practitioner - Pathology 6800085861

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Austin Pathology AssociatesGroup PAC ID 7012902539, 76 clinicians

Practice addresses (Care Compare)

1625 Medical Ctr Dr
El Paso, TX 79902-5005
Phone (915) 747-4000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Austin Pathology Associates Anatomic Pathology & Clinical Pathology CurrentSince Nov 24, 2024 Accepting new patients
Baylor College of Medicine CurrentSince Jul 1, 2011 Accepting new patients
Baylor College of Medicine CurrentSince Jul 1, 2011 Accepting new patients
Austin Pathology Associates Anatomic Pathology & Clinical Pathology CurrentSince Nov 24, 2024 Accepting new patients
Gulf Coast Pathology Program PLLC Anatomic Pathology & Clinical Pathology Current Accepting new patients
Pathlink of Texas, PLLC Anatomic Pathology & Clinical Pathology CurrentSince Nov 14, 2020 Accepting new patients

Locations

5700 Southwyck Blvd
Toledo, OH 43614

4900 Mueller Blvd
Austin, TX 78723
Phone (512) 324-0165

901 W Ben White Blvd
Austin, TX 78704
Phone (512) 342-2382

1625 Medical Center Dr
El Paso, TX 79902
Phone (915) 577-7746

2001 N Oregon St
El Paso, TX 79902
Phone (915) 577-6011

3280 Joe Battle Blvd
El Paso, TX 79938
Phone (915) 577-6000

2000 Scenic Dr
Georgetown, TX 78626
Phone (512) 863-2117

2 Greenway Plz
Ste 900
Houston, TX 77046
Phone (713) 798-1835

1504 Taub Loop
Houston, TX 77030
Phone (713) 873-2860

Organizations & group practices 7

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 1

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538956800000",
    "number": "1679653075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1265 UNION AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381043415",
            "telephone_number": "901-516-7182",
            "fax_number": "901-276-5474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 UNION AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381043415",
            "telephone_number": "901-516-7182",
            "fax_number": "901-276-5474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUCIRICA",
        "first_name": "RODOLFO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2018-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TN",
            "license": "19251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q033049",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679653075",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.